短时受精联合早补救ICSI在辅助生殖技术中的应用研究

Application of short gamete co-incubation joint early rescue ICSI in assisted reproductive technology

目的比较短时受精与长时受精的临床应用效果,评估短时受精联合早补救ICSI在辅助生殖技术中的应用价值。方法回顾分析9039个周期常规受精的患者,分为短时受精组和长时受精组,分别比较两组及两组同时期行R-ICSI和LICSI组的受精情况、卵裂率、临床妊娠率等,并进行统计学分析。结果两组的多精受精率(≥3PN)、受精率、种植率及自然流产率无统计学差异(P>0.05)。短时受精的2PN率(65.22%vs 43.06%,P<0.01)、卵子利用率(48.84%vs 37.53%,P<0.01)、0PN率(21.59%vs 37.84%,P<0.05)、1PN率(4.85%vs 13.43%,P<0.05)、卵裂率(96.87%vs 93.06%,P<0.01)、优质胚胎率(50.66%vs 44.63%,P<0.01)、取消移植率(4.95%vs 16.08%,P<0.01)、胚胎利用率(81.25%vs 63.91%,P<0.01)、临床妊娠率(53.49%vs35.85%,P<0.01)及抱婴回家率(37.75%vs 14.40%,P<0.01)明显高于长时受精组。R-ICSI的受精率(44.79%vs 24.70%)、卵裂率(98.90%vs 68.25%)、优质胚胎率(40.38%vs 31.79%)、卵子利用率(62.90%vs 45.10%)及临床妊娠率(48.98%vs 29.23%)明显高于L-ICSI,差异有统计学意义(P均<0.05)。结论短时受精可以明显增加2PN受精率,在一定程度上改善了胚胎质量,从而改善临床结局。短时受精失败后及时行R-ICSI能极大地提高卵子利用率,并能获得很好的临床妊娠结局,对预防及降低受精失败有重要意义。短时受精联合R-ICSI在辅助生殖中有较好的应用前景。

Objective To evaluate the application value of short gamete co-incubation joint early remedial ICSI in assisted reproductive technology by comparing the clinical application effect of short gamete co-incubation and long gamete co-incubation. Methods A retrospective analysis was made on the clinical data of 7316 patients with conventional fertilization cycle,which were divided into short gamete co-incubation and long gamete co-incubation group. Compared the fertilization,cleavage rate,clinical pregnancy rate,etc. Results There were no statistical difference of 3 PN rate,fertilization rate,planting rate and spontaneous abortion rate between short gamete co-incubation and long gamete co-incubation group. The 2 PN rate(65.22% vs 43.06%,P<0.01),eggs utilization (48.84% vs 37.53%,P<0.01),0 PN rate (21.59% vs 37.84%,P<0.05),1 PN rate (4.85% vs 13.43%,P<0.05),cleavage rate (96.87% vs 93.06%,P<0.01),high quality embryos rate (50.66% vs 44.63%,P<0.01),cancel the graft rate (4.95% vs 16.08%,P<0.01),embryo utilization (81.25% vs 63.91%,P<0.01),clinical pregnancy rate (53.49% vs 35.85%,P<0.01) and carry baby home rate (37.75% vs 14.40%,P<0.01) of the short gamete co-incubation group were obviously higher than that of the long gamete co-incubation group. The fertilization rate (44.79% vs 24.70%),cleavage rate (98.90% vs 68.25%),high quality embryos rate (40.38% vs 31.79%),eggs utilization (62.90% vs 45.10%) and clinical pregnancy rate (48.98% vs 29.23%) of the short gamete co-incubation group were obviously higher than that of L-ICSI,the difference had statistical significance(P<0.05). Conclusion Short gamete co-incubation could significantly increase the 2 PN rate and improve the quality of embryos,so as to improve clinical outcomes. R-ICSI could greatly improve the utilization rate of eggs and obtain good clinical pregnancy outcome,which had an important significance in preventing and reducing the fertilization failure. In short,short gamete co-incubation joint R-ICSI has a good application prospect in assisted reproduction Technology.