短时受精联合早期补救卵胞浆内单精子注射技术的应用价值

Application of short-time insemination combined with early recovery ICSI technology

目的探讨早期补救卵胞浆内单精子注射(ICSI)技术在短时受精治疗周期中的应用价值。方法选取2018年-2020年在联勤保障部队解放军第904医院生殖中心进行体外受精(IVF)治疗的患者的454个周期作为研究对象。根据是否行早期补救ICSI技术,分为常规IVF组(n=352)与补救ICSI组(n=102)。比较两组的基本情况及实验室资料。结果补救ICSI组原发不孕比例、不明原因不孕比例、不育年限、窦卵泡数显著大于常规IVF组,卵泡刺激素(FSH)水平低于常规IVF组,差异具有统计学意义(P<0.01);两组年龄及体重指数比较,差异无统计学意义(P>0.05)。两组精液量、精液浓度、前向运动精子率(PR)、正常形态精子率比较,差异无统计学意义(P>0.05)。补救ICSI组的获卵数和成熟卵数显著高于常规IVF组(P<0.01);补救ICSI组的≥3PN率和囊胚形成率与常规IVF组比较,差异无统计学意义(P>0.05);常规IVF组的受精数高于补救ICSI组(P<0.05);常规IVF组的优胚率和可移植胚胎率显著高于补救ICSI组(P<0.05)。两组种植率、流产率和妊娠率比较,差异无统计学意义(P>0.05)。结论短时受精联合早期补救ICSI技术能够有效改善IVF受精失败或低受精结局。

Objective To evaluate the value of application of short-time insemination combined with early remedial intracytoplasmic sperm injection(ICSI)technology.Methods A total of 454 cycles of in vitro fertilization(IVF)at the Reproductive Center of the 904th Hospital of Joint Logistic Support Force of PLA were selected as subjects.According to whether early remedial ICSI was performed,the patients were divided into the remedial ICSI group(n=102)and the conventional IVF group(n=352).The basic conditions and laboratory data of the two groups were compared.Results The proportion of primary infertility,unexplained infertility,infertility duration and number of sinus follicles in the ICSI group were significantly higher than those in the conventional IVF group,and the level of follicle stimulating hormone(FSH)was lower than that in the conventional IVF group(P<0.01).There was no significant difference in age and body mass index between the two groups(P>0.05).There were no significant differences in semen volume,concentration,PR ratio and normal morphology rate between the two groups(P>0.05).The number of obtained ovums and mature ovums in ICSI group was significantly higher than that in conventional IVF group(P<0.01).There were no significant differences in≥3PN rate and blastocyst rate between the remedial ICSI group and the conventional IVF group(P>0.05).The number of fertilization in conventional IVF group was higher than that in remedial ICSI group(P<0.05).The optimal embryo rate and transplantable embryo rate in conventional IVF group were significantly higher than those in remedial ICSI group(P<0.05).There were no significant differences in implantation rate,abortion rate and pregnancy rate between the two groups(P>0.05).Conclusions Short-term insemination combined with early remedial ICSI is an effective treatment for IVF failure or low fertilization.