短时受精失败早补救的临床应用

Clinical Application of Early Rescue ICSI in Short-term in Vitro Fertilization Failure

目的了解短时受精早补救性卵胞质内单精子显微受精(ICSI)与晚补救性ICSI对体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析自2010年6月至2012年6月在南宁市第二人民医院生殖中心实施体外受精-胚胎移植发生完全性受精失败的97例患者共97个周期,分析受精后20 h进行补救(晚补救)的30个周期共30例患者(A组),受精后6 h进行补救(早补救)的67个周期共67例患者(B组),统计两组的平均获卵数、正常受精率、多精受精率、优质胚胎率、冷冻胚胎率及临床妊娠率。结果早期补救性(B组)与晚补救(A组)的ICSI平均获卵数(12.10 vs 10.10,P>0.05)、正常受精率(84.73%vs 79.92%)、冷冻胚胎率(24.90%vs 24.10%)相比,差异均无统计学意义(χ2=1.754,0.923,0.173,P>0.05);但多精受精率(2.53%vs 0.00%)、优质胚胎率(40.72%vs 5.64%)、临床妊娠率(40.30%vs 10.00%),早期补救性(B组)显著高于晚补救组(A组),差异均有统计学意义(χ2=2.434,4.560,8.905,P<0.05)。结论短时受精早补救可以获得与常规IVF相似的临床结局,可以作为受精失败补救措施的最佳选择。

Objective To evaluate the outcome of early intracytoplasmic sperm injcction（ICSI） and late ICSI for in vitro fertilization and embryo transfer. Methods From June 2010 to June 2012,30 cases of 20 hours after fertilization from Reproduction Center of Nanning Second People＇s Hospital were classified into group A（ late [CSI） ,67 eases of 6 hours after fertilization into group B（ Early ICSI）. The number of retrieved oocytes, fertilization rate, multi-PN rate, good quality embryo rate, frozen embryo rate and clinical pregnancy rate were compared between group A and group B. Results The results showed the number of retrieved oocytes （ 12.10 vs 10.10, P 〉 0.05 ） , fertilization rate （ 84.73 % vs 79.92 % ） , frozen embryo rate （ 24.90 % vs 24.10% ）of Group B and Group A were not statistically significant （X2 = 1. 754,0. 923,0. 173 ,P 〉 0. 05 ）, but the rates of muhi-PN（2.53% vs 0.00% ） ,good quality embryo（40.72% vs 5.64% ） and clinical pregnancy （40.30% vs 10.00% ） of group B were found higher than group A,with statistically significant differences （X2 = 2. 434,4. 560,8. 905 ,P 〈0.05 ）. Conclusion Early ICSI may be the best choice for in vitro fertilization failure rescue, which has similar clinical outcomes of IVF.