短时授精对IVF临床结局和新生儿结局的影响

Effects of brief insemination on the clinical outcomes and neonatal outcomes of IVF

目的:探讨短时授精是否对IVF临床结局和新生儿结局有影响。方法:回顾性分析2019年2月至2020年3月IVF 797周期,通过不同精液条件选择性短时授精(bIVF)384和常规授精(cIVF)413例;和冷冻日期2019年2月至2020年3月单囊胚冻融周期移植(FET)326例,FET-bIVF 149例和FET-cIVF 177例,比较两组的临床结局和新生儿结局。结果:与cIVF相比,虽然受精结局bIVF显著低于cIVF正常受精率、IVF完全不受精比例和IVF低受精比例差异极显著(P<0.01),但无论新鲜周期还是FET,两组的临床结局和新生儿结局差异不显著,包括临床妊娠率(新鲜周期移植51.40%vs 50.69%,P>0.05;FET 69.80%vs 66.67%,P>0.05)、活产率(新鲜周期移植42.99%vs 43.75%,P>0.05;FET 58.39%vs 53.67%,P>0.05)、新生儿畸形风险(新鲜周期移植0.00%vs 2.53%,P>0.05;FET 1.15%vs 2.11%,P>0.05)等。结论:采用选择性短时授精可以有效防止IVF完成不受精或低受精,而且不影响其临床结局和新生儿结局。

Objective:To explore whether brief insemination has an impact on the clinical outcome and neonatal outcomes of IVF.Methods:The IVF 797 cycle from February 2019 to March 2020 was retrospectively analyzed with 384 case of brief insemination IVF(bIVF)and 413 case under different semen conditions for selective brief insemination(BI).Also with the single blastocyst cryopreservation from February 2019 to March 2020 on frozen embryo transfer(FET),149 FET-bIVF and 177 FET-cIVF cases were compared by the clinical and neonatal outcomes.Results:Compared with cIVF,although the fertilization outcomes bIVF were significantly lower than cIVF,such as the normal fertilization rate,IVF complete non-fertilization rate and IVF low fertilization rate(P<0.01);both the fresh transfer cycles and FET,the clinical outcomes and neonatal outcomes of the two groups were no significant difference,including the clinical pregnancy rate(fresh transfer 51.40%vs 50.69%,P>0.05;FET 69.80%vs 66.67%,P>0.05),live birth rate(fresh transfer 42.99%vs 43.75%,P>0.05;FET 58.39%vs 53.67%,P>0.05),risk of neonatal malformation(fresh transfer 0.00%vs 2.53%,P>0.05;FET 1.15%vs 2.11%,P>0.05),etc.Conclusion:Selective BI can effectively prevent IVF from total fertilization failure or low fertilization,and does not affect its clinical and neonatal outcomes.