存在受精失败风险患者中应用分半IVF/ICSI的临床结局分析

Analysis of Clinical Outcomes of Half-ICSI in Patients with High Risk of Fertilization Failure

目的 探讨分半ⅣF/ICSI（half-ICSI）在有受精失败风险患者中的临床应用价值.方法 2009年8月～2010年8月于我科行half-ICSI共36周期,同一周期取得的卵子随机分半,分别进行常规体外受精（IVF）与卵胞浆内单精子显微注射（ICSI）,比较不同受精方式的受精率、卵裂率及优质胚胎率,并与同期接受常规IVF的连续312个周期作为对照.结果 Half-ICSI周期中ICSI受精率（81.38%）明显高于IVF受精率（41.28%）,IVF完全受精失败率（19.44%）及受精低下率（27.78%）明显高于ICSI完全受精失败率（0）及受精低下率（5.56%）,差异有统计学意义（P＜0.05）;IVF和ICSI的卵裂率及优质胚胎率比较,差异无显著性（P＞0.05）;Half-ICSI周期的胚胎种植率及临床妊娠率同常规IVF周期比较,差异无显著性（P＞0.05）.结论 存在受精失败风险患者应用half-ICSI,可以在一定程度上增加其受精率,减少取消移植的风险,增加妊娠机会.

Objective To explore the clinical outcomes of half-lCSI in patients with high risk of fertilization failure. Methods Thirty-one cases treated with half-ICSI for 31 cycles from August 2009 to August 2010 in our section were analysed. The sibling oocytes were divided into 2 groups randomly,one group adopted in vitro fertifization（IVF） insemination while the other adopted intracytoplasmic sperm injection （ ICSI ）. The rates of fertilization, cleavage, high quality embryos were compared between the two fertilization methods. Three hundred and twelve consecutive cycles of IVF were chosen as the control group. Results In the half-ICSI group, the fertilization rate of ICSI （ 81.38% ） was significantly higher than that of IVF（41.28% ） （P 〈 0.05）, and so were the rates of complete fertilization failure（ 19.44%） and low fertilization（ 16.67%） of IVF than those of ICSI（0 and 2.78% ）. No significant differences were observed in the rates of cleavage and high quality embryos between the two groups（P 〉 0.05） ,and so were the rates of implantation and clinical pregnancy（ P 〉 0.05）. Conclusion It can increase the rate of fertilization while reduce the risk of complete fertilization failure for the patients with high risk of fertilization failure to use half-ICSI. And the patients will obtain more opportunity to get pregnant.