获卵少患者体外授精方式的临床分析

Clinical analysis of the way of in vitro fertilization for patients with low oocytes retrieved

目的:探讨授精方式对体外受精-胚胎移植(IVF-ET)治疗中获卵少患者临床结局的影响。方法:回顾性分析2013年1月-2016年6月行体外受精-胚胎移植治疗中获卵数≤3个且男方精液无明显异常的190个周期,比较常规体外受精(IVF组97个周期)和卵胞浆内单精子注射(ICSI组93个周期)的临床结局。结果:IVF组和ICSI组患者夫妇基础资料差异无统计学意义;两组正常受精率(61.6%vs.59.9%)、卵裂率(91.8%vs.97.3%)、优胚率(67.9%vs.66.1%)、可利用胚胎率(91.1%vs.94.5%)、完全受精失败率(11.3%vs.20.4%)、取消周期率(35.1%vs.28.0%)、着床率(32.1%vs.20.8%)、临床妊娠率(46.0%vs.27.3%)、临床活产率(83.3%vs.60.0%)、累计妊娠率(35.7%vs.24.1%)、累计活产率(32.1%vs.18.5%),差异均无统计学意义;两组多精受精率(14.1%vs1.6%)差异有统计学意义(P<0.05)。结论:获卵数≤3个且男方无ICSI指征的患者,选择ICSI可减少多精授精,但临床结局无明显改善。

Objective：To explore the clinical outcomes of different ways of in vitro fertilization（IVF）or intracytoplasmic sperm injectionon（ICSI）for patients with a little oocytes retrieved cycles.Methods：190 cycles with no more than3 oocytes retrieved and used normal semen between January 2013 and June 2016 were retrospective analyzed.The clinical outcomes of patients in IVF group（n=97）and in ICSI group（n=93）were compared.Results：Basal characteristics were similar in both group including the normal fertilization rate（61.6% vs 59.9%）,the cleavage rate（91.8%vs97.3%）,the high quality embryo rate（67.9% vs 66.1%）,the complete fertilization failure rate（11.3% vs 20.4%）,the available embryto rate（91.1% vs 94.5%）,the cycle cancellation rate（35.1% vs 28.0%）,the implantation rate（32.1% vs 20.8%）,the pregnancy rate（46.0% vs 27.3%）,the clinical live birth rate（83.3% vs 60.0%）,the cumulative pregnancy rate（35.7% vs 24.1%）and the cumulative birth rate（32.1% vs 18.5）,which all had no significant difference（P〉0.05）.However,there was significant difference in the multiple precision number（PN）rate（14.1% vs1..6%）（P〈0.05）.Conclusion：When retrieved oocyte number is equal to or less 3,and patients has no ICSI indications,selecting ICSI can reduce the multiple PN rate,but the other clinical outcomes have no significant improvement.