禁欲天数对体外受精和卵胞浆内单精子注射胚胎发育及妊娠结局的影响

The influence of abstinence time on embryo development and pregnancy outcomes in the IVF and ICSI cycles

目的探讨禁欲天数对体外受精(in vitro fertilization,IVF)或卵胞浆内单精子注射(intro cytoplasmic sperm injection,ICSI)胚胎发育及妊娠结局的影响。方法回顾性分析邢台不孕不育专科医院生殖中心2017年1月至2019年12月行IVF/ICSI-ET治疗的2167个周期,包括1699个IVF周期(A组)和468个ICSI周期(B组)。分别根据男方禁欲天数的不同各分为两个亚组:A1组,IVF禁欲天数1~3 d,共806个周期;A2组:IVF禁欲天数4~7 d,共893个周期;B1组,ICSI禁欲天数1~3 d,共217个周期;B2组:ICSI禁欲天数4~7 d,共251个周期,分析禁欲天数对IVF和ICSI胚胎发育和妊娠结局的影响。结果IVF和ICSI两亚组患者的基础资料比较,差异均无统计学意义(P>0.05),IVF和ICSI两亚组的2 PN受精率、2 PN卵裂率、可用胚胎率、可用囊胚形成率、移植胚胎数目及内膜厚度等均无显著差异(P>0.05),A2组妊娠率及种植率均显著高于A1组(P<0.05),B2组妊娠率及种植率有高于B1组的趋势,但差异无统计学意义(P>0.05)。结论男方禁欲天数在4~7 d能够显著提高IVF妊娠率及种植率,ICSI有增高的趋势但无显著差异。

Objective To investigate the influence of abstinence time on embryo development and pregnancy outcomes in the IVF and ICSI cycles.Methods We retrospectively analyzed 2167 IVF/ICSI-ET cycles from January 2017 to December 2019 in reproductive center Xingtai Infertility Specialist Hospital,including 1699 IVF cycles(group A)and 468 ICSI cycles(group B).According to the abstinence time,the patients were placed to four groups:group A1(806 cycles):abstinence time 1~3 days of IVF cycles;group A2(893 cycles):abstinence time 4~7 days of IVF cycles;group B1(217 cycles):abstinence time 1~3 days of ICSI cycles;group B2(251 cycles):abstinence time 4~7 days of ICSI cycles;the embryonic development and the pregnancy outcomes were compared among the groups of IVF and ICSI cycles.Results There was no statistical difference in the basic data between the subgroups(P>0.05).The 2 PN fertilization rate,2 PN cleavage rate,the available embryo rate,the available blastocyst rate,the number of embryo transferred and the endometrial thickness had no significantly difference between the subgroups(P>0.05).The pregnancy rate and implantation rate of group A2 were significantly higher than group A1(P<0.05),the pregnancy rate and implantation rate of group B2 were higher than group B1,but there was no significantly difference(P>0.05).Conclusion The male abstinence time of 4~7 days can significantly improve the pregnancy rate and implantation rates of IVF cycles,and there was an increasing tendency in the ICSI cycles but no significantly difference.