常规IVF受精失败后行补救ICSI与直接ICSI的临床比较分析

The value of rescue ICSI versus that of direct ICSI following fertilization failure in conventional IVF

目的:探讨常规体外受精(IVF)失败后行补救性卵母细胞浆内单精子注射(Rescue ICSI)的临床价值。方法:回顾性分析2009年6-12月在我院生殖中心接受IVF-ET治疗,常规IVF受精完全失败行Rescue ICSI的患者共29个周期(Ⅰ组),与同期用男方射出精液直接行ICSI的70个周期(Ⅱ组)进行比较,两组患者均为首次接受体外受精/胚胎移植(IVF-ET)治疗。结果:Ⅰ组正常受精率、优质胚胎率、临床妊娠率分别为(80.8±16.2)%、(76.6±24.6)%、37.9%,Ⅱ组正常受精率、优质胚胎率、临床妊娠率分别为(82.9±15.9)%、、(72.7±24.4)%、41.4%,Ⅰ组与Ⅱ组相比差异无统计学意义(P>0.05);Ⅰ组卵裂率为(91.7±13.6)%,Ⅱ组为(97.4±6.8)%,两组差异有统计学意义(P<0.05)。结论:补救ICSI可提高受精率,改善临床妊娠结局,可以作为常规IVF受精失败后的补救措施。

Objective To explore the clinical value of rescue intracytoplasmic sperm injection （Rescue iCSI） following fertilization failure in conventional IVF. Methods 29 rescue ICSI cycles following total fertilization failure in conventional IVF （group Ⅰ ） and 70 direct ICSI cycles （group Ⅱ ） were performed in our hospital between June 2009 and December 2009. The clinical outcomes were compared between the two groups. Results The normal fertilization rate, high-quality embryo rate, and clinical pregnancy rate did not differ significantly between the two groups [（80.8 ± 16.2）% vs. （82.9 ± 15.9）%, （76.6 ± 24.6）% vs. （72.7 ± 24.4）%, and 37.9% vs. 41.4% ;P 〉 0.05]. There was a significant difference in the cleavage embryo rate between rescue ICSI than direct ICSI [ （91.7 ± 13.6）% vs. （97.4± 6.8）%, P 〈 0.05 ]. Conclusions Rescue ICSI may improve the fertilization rate and clinical outeomes. It can be performed after fertilization failure in conventional IVF.