短时受精联合早期补救卵泡浆内单精子注射在非男性不孕治疗中的临床结局

Clinicaloutcomes of short-time fertilization combined with early rescue intracytoplasmic sperm injection in treatment of non-male infertility

目的探讨短时受精联合早期补救卵泡浆内单精子注射(ICSI)在非男性不孕治疗中的临床应用价值。方法回顾性分析2014年1月至2017年1月在安徽医科大学第一附属医院妇产科生殖医学中心行助孕治疗的患者,选择其中首次体外受精(IVF)中卵子完全不受精,行早期补救ICSI的患者,共197例,为A组;因第1周期行IVF或补救ICSI未妊娠、第2周期行直接ICSI的患者,共201例,为B组;以同期因单纯男性不育因素行直接ICSI的患者,共408例,为对照组(C组)。分析比较各组的正常受精率、卵裂率、优质胚胎率和累计妊娠率等情况。结果 A、B、C 3组在正常受精率(80.33%、80.49%、80.59%)、卵裂率(96.09%、96.57%、96.08%)上差异无统计学意义(P>0.05);A、B组的优质胚胎率(44.86%、45.09%)、累计妊娠率(69.54%、69.65%)低于C组(57.30%,80.14%),差异有统计学意义(P<0.05),而A、B组比较,差异无统计学意义(P>0.05)。结论短时受精联合早期补救ICSI可以降低受精失败的发生,并与重复周期行ICSI有相似的妊娠结局,值得临床推广。

Objective To investigate the clinical application value of short-time fertilization combined with early rescue intracytoplasmic sperm injection（ ICSI） in treatment of non-male factor infertility. Methods A retrospective analysis was conducted on those patients underwent assisted reproduction treatment in our center between Jan 2014 and Jan 2017,and 197 patients with early rescue ICSI because of complete fertilization failure in primary in vitro fertilization（ IVF） were chosen as the study group A. Meanwhile,201 patients with secondary direct ICSI because of fertilization failure in primary IVF or rescue ICSI were chosen as the study group B,and other 408 patients with direct ICSI because of single male factor infertility were selected as the control group C. The rates of normal fertilization,cleavage,high-quality embryos and cumulative pregnancy among the three groups were calculated and compared. Results There had no significant differences among the three groups in the normal fertilization rate（ 80. 33%,80. 49%,80. 59%） and cleavage rate（ 96. 09%,96. 57%,96. 08%; P〉0. 05）. In the study groups A and B,the rates of high-quality embryos（ 44. 86%,45. 09%） and cumulative pregnancy（ 69. 54%,69. 65%） were all significantly lower than those in the control group（ 57. 30%,80. 14%; P〈0. 05）,but no significant difference was found between group A and B（ P〉0. 05）. Conclusion Use of short-time fertilization combined with early rescue ICSI could reduce the risk of fertilization failure and has similar pregnancy outcomes with repeated ICSI treatment,so it is worthy of clinical application.