卵透明带结合法筛选精子在男性不育症卵胞浆内单精子注射治疗中的应用

Outcome of modified intracytoplasmic sperm injection using zona pellucida -bound spermatozoa in male ;infertility

目的：探讨采用卵透明带上的精子行卵胞浆内单精子注射（ICSI）的治疗结局。方法选择因单纯男方少、弱、畸精症而不育并符合ICSI治疗指征的患者82例，依据ICSI病历号末位的奇数、偶数分成传统ICSI对照组和利用卵透明带上的精子行ICSI的观察组，比较两组正常受精率、卵裂率、优胚率、种植率、临床妊娠率和早期流产率。结果两组女方年龄、不育年限、成熟卵（MII）率、正常受精率、卵裂率的差异均无统计学意义（均 P ＞0．05）；观察组种植率、临床妊娠率（46．6％、63．3％）均明显高于对照组（38．5％、53.6％），但差异均无统计学意义（均P＞0．05）；观察组可利用胚胎率、优质胚胎率（73．9％、51．0％）显著高于对照组（65.8％、38．6％），差异均有统计学意义（χ2＝5．84、11．6，均P＜0．05）。结论应用自体卵透明带上的精子进行ICSI，能有效提高ICSI胚胎质量。

Objective To investigate the treatment outcome of modified intracytoplasmic sperm injection （ICSI）using zona pellucida（ZP）-bound sperm.Methods 82 patients with less,weak,abnormal sperm disease who were conformed to ICSI,were divided into traditional ICSI group and the group of modified ICSI using ZP-bound sperm according to ICSI case number.The results of normal fertilization rate,cleavage rate,high-quality embryo rate, planting rate,clinical pregnancy rate and early abortion rate were compared.Results The women＆#39;s age,the sterility year,mature egg rate,normal fertilization rate,cleavage rate in the two groups had no statistically significant differ-ences （all P〉0.05）.The planting rate and clinical pregnancy rate of the observation group （46.6%,63.3%）were higher than those of the control group（38.5%,53.6%）,but there were no statistically significant differences（all P〉0.05）.The using embryo rate and high-quality embryo rate of the observation group （73.9%,51.0%）were signifi-cantly higher than those of control group（65.8%,38.6%）,the differences were statistically significant（χ2 =5.84,χ2 =11.6,all P〈0.05）.Conclusion Modified ICSI using ZP-bound sperm can effectively improve the embryos quality in ICSI.