补救卵母细胞浆内单精子注射治疗的临床结局分析

Analysis of the clinical outcomes of rescue intracytoplasmic sperm injection

体内精卵受精是一个复杂的过程，包括卵母细胞成熟、精子成熟、精子获能、精子透明带结合、配子融合、卵子激活和精子解聚等一系列过程，其中任何过程发生障碍都可能造成受精失败。在常规体外受精-胚胎移植（IVF—ET）周期中，常有一些周期存在受精完全失败的情况，具体原因在每一个受精失败周期中各不同。卵胞浆内单精子注射（ICSI）技术是直接将单一精子注射人卵细胞浆内，跨越了常规IVF时精卵结合等过程，

Objective： To analyze the clinical outcomes of rescue intra-cytoplasmic sperm injection （ICSI） after a complete fertilization failure in in vitro fertilization/embryo transfer cycle （IVF-ET）. Methods： A total of 44 conventional IVF cycles failed to achieve fertilization and were treated with rescue ICSI 18-20 hours after the failed fertilization. The fertilization rate, cleavage rate, quality embryo rate and pregnancy rate in the rescue ICSI group were compared with those in the conventional ICSI group that were performed in the corresponding period of time. Results： The fertilization rate, cleavage rate, quality embryo rate and pregnancy rate in the rescue ICSI group were all significantly lower than those in the conventional ICSI group （63. 18%, 63. 35%, 57.83% and 22.58% vs. 70.62%, 94.06%, 84.76% and 50.00%, respectively）. The miscarrage rate was similar in both groups. No birth defects or other major abnormalities were found in any of 7 newborns in rescue ICSI group. Conclusions： The lower fertilization rate and lower pregnancy rate in rescue ICSI group might be related to the over maturation of oocytes. Rescue ICSI could be a rescue for those with fertilization failure in conventional IVF cycles.