对单个卵子不同授精方式的妊娠结局分析

Pregnancy outcomes of different insemination methods in cycles with single oocyte retrieved

目的探讨常规体外受精(IVF)和单精子卵胞浆内显微注射(ICSI)两种不同授精方式对仅获得单个卵子周期的临床结局分析.方法回顾性分析接受治疗并仅获得单个卵子的525对不孕夫妇的777个周期的病例资料.根据精液质量分为3组:IVF组(563个周期),严重男性因素SMF-ICSI组(151个周期),非严重男性因素NSMF-ICSI组(63个周期).比较各组间正常受精率、可利用胚胎率、优质胚胎率、每周期临床妊娠率.结果IVF组、SMF-ICSI组和NSMF-ICSI组的正常受精率分别为70.3%、81.4%和80.7%,差异有统计学意义(P<0.05);可利用胚胎率分别为81.6%、84.8%和87.0%;优质胚胎率分别为42.2%、53.3%和34.8%;每周期临床妊娠率分别为19.8%、12.5%和11.1%;可利用胚胎率、优质胚胎率和每周期临床妊娠率差异均无统计学意义(P>0.05).结论对每周期只获得单个卵子的患者应严格根据男方精液质量及过往病因选择授精方式.

Objective To compare the effect of intracytoplasmic sperm injection(ICSI) and conventional in vitro fertilization(IVF) on pregnancy outcome for infertile women with single oocyte retrieved. Methods A total of 777 cycles from 525 infertile patients who had single oocyte retrieved during IVF/ICSI treatments were analyzed. The patients were allocated into three groups based on the fertilization method and semen quality(IVF, 563 cycles;ICSI severe male factor, 151 cycles;ICSI non-severe male factor, 63 cycles). The normal fertilization rate, the available embryo rate, the high quality embryo rate and the clinical pregnancy rate per cycle were compared among the groups. Results Among IVF, ICSI/SMF and ICSI/NSMF groups, there were significant differences in the normal fertilization rates(70.3%, 81.4%, and 80.7%,respectively, P<0.05). There was no significant difference in the available embryo rate(81.6%, 84.8%, and 87.0%, respectively), the high quality embryo rate(42.2%, 53.3%, and 34.8%, respectively), or clinical pregnancy rate per cycle(19.8%, 12.5%, and 11.1%, respectively)(P>0.05) among IVF, ICSI-SMF and ICSI-NSMF groups. Conclusion The application of insemination methods should be based primarily on semen quality, in combination with the patients′ previous history in IVF/ICSI cycles with single oocyte retrieved.