常规体外受精失败后行补救性卵胞质内单精子注射的临床总结

Analysis of the clinical outcomes of rescue ICSI after total fertilization failure in conventional IVF

目的回顾分析常规IVF受精完全失败在临床中的发生情况及受精失败后应用补救性卵母细胞内单精子注射（ICSI）的临床结局。方法总结1999年5月-2009年5月，在我中心行常规IVF患者中，受精完全失败的发生情况。回顾性分析了2004年1月-2009年5月，因受精完全失败行补救性ICSI后的临床结局。结果1999年至2009年5月，我中心共行常规IVF8359个周期，其中，受精完全失败232个周期，发生率为2．78％。2004年1月至2009年5月，共184个周期受精完全失败，资料完整，对其中115个周期共838个MII期卵子行补救性ICSI，其受精率、卵裂率与优质胚胎率分别为71.0％、93．78％和51．79％；临床妊娠率为11％，获得活产儿5个。结论补救性ICSI能获得较高的受精率和卵裂率，降低周期取消率，但并没有明显增加活产儿出生数，改善妊娠结局。

Objective： To analyze the clinical outcomes of rescue ICSI after total fertilization failure in IVF. Methods： Summarize the rate of total fertilization failure in conventional IVF in our centre from 1999 to 2009. Retrospectively analyze the results of rescue ICSI （ 838 MII oocytes of 1192 in 115 cycles from January 2004 to May 2009）. Results ： The rate of total fertilization failure is 2. 78% in our center from 1999 to 2009 （232 cycles in 8359 conventional IVF cycles）. From January 2004 to May 2009, 838 MII oocytes received rescue ICSI. The rate of normal fertilization and cleavage were 71% and 93.78% respectively. On the day of embryo transfer, the good quality embryos rate was 51.79%. The biochemical pregnancy rate was 11% , and five babies were born. Conclusion： Rescue ICSI can achieve high rate of fertilization and cleavage, and produce variable embryos and pregnancies, but can not improve the pregnancy results.