Objective To investigate clinical outcomes in patients who were at more precise criteria risks for fertilization failure and were treated with selective, short-term fertilization （oocytes and sperm co-incubated for ...Objective To investigate clinical outcomes in patients who were at more precise criteria risks for fertilization failure and were treated with selective, short-term fertilization （oocytes and sperm co-incubated for 4 h） and early rescue intracytoplasmic sperm injection （ICSI）. Methods A retrospective analysis was performed on 2023 women undergoing assisted reproductive technology （ART）. They were assigned to 4 groups： short-term in vitro fertilization （short-term IVF,, group A, n=217）, regular IVF （oocytes and sperm coincubated overnight, group B, n=1475）, short-term IVF and early rescue ICSI （shortterm ICSI, group C, n=94）, and regular ICSI （group D, n=237）. Results In group A, 69.8% （217/311） achieved normal fertilization rates, and the complete fertilization failure rate （fertilization rate was 0%） was 12.9% （40/311）. But all of the fertilization failure oocytes got rescue ICSI. In group B, the complete fertilization failure rate was 1.1% （19/1 692）. The fertilization rate, 2 PN （pronucleus） rate, and i PN rate were significantly lower in group A than those in group B （70.9% vs 80.8%, 57.8% vs 66.3%, and 3.5% vs 6.2%, respectively）. No significant differences were observed in clinical pregnancy rates and birth defect rates between groups A and B. The fertilization rates in groups C and D did not significantly differ （77.9% vs 76.2%）, which was also true for birth defect rates. The clinical pregnancy rate of group C was higher than that of group D （51.2% vs 42.3%）, but this difference was not significant （P〉0. 05）.Conclusion These results suggested that selective, short-term fertilization can result in effective outcomes for patients who were at high risk for fertilization failure.展开更多
Objective To evaluate the application value of rescue ICSI in fertilization failure after conventional IVF and choose the best rescue window before oocyte aging according to the results of rescue ICSI performed in dif...Objective To evaluate the application value of rescue ICSI in fertilization failure after conventional IVF and choose the best rescue window before oocyte aging according to the results of rescue ICSI performed in different time. Methods The data of 93 IVF cycles were analyzed retrospectively. Rescue ICSI was performed in these cycles after conventional IVF failure. Because of the different rescue time, these cycles were divided into two groups： early rescue group （group A, 77 cycles, rescue ICSI performed 4-8 h after conventional IVF） and late rescue group （group B, 16 cycles, rescue ICSI performed 20-22 h after conventional IVF）. Results There were no statistically significant differences in age of female, duration of infertility, number of oocytes retrieved every cycle. The normal fertilization rate, pregnancy rate and implantation rate were decreased in group B compared with those in group A （P〈0.05）. In group A, the normal fertilization rate of rescue ICSI performed 4-6 h after conventional IVF （group A1） was increased compared with that of rescue ICSI performed 6-8 h （including 6 h） after conventional IVF （group A2）（66.5% vs 55.9%）（P〈0.05）; while the abnormal fertilization rate in group A1 was decreased compared with group A2 （9.0% vs 14.4%）（P〈0.05）. Clinical pregnancy rate was slight higher in group A1 than in group A2, though this failed to be significantly different. Conclusion Rescue ICSI is effective if fertilization was failure after conventional IVF, the most important thing is to choose the reasonable rescue window before oocyte aging when ICSI is performed.展开更多
基金supported by Science and Information Technology of Guangzhou(2012Y2-00022)
文摘Objective To investigate clinical outcomes in patients who were at more precise criteria risks for fertilization failure and were treated with selective, short-term fertilization （oocytes and sperm co-incubated for 4 h） and early rescue intracytoplasmic sperm injection （ICSI）. Methods A retrospective analysis was performed on 2023 women undergoing assisted reproductive technology （ART）. They were assigned to 4 groups： short-term in vitro fertilization （short-term IVF,, group A, n=217）, regular IVF （oocytes and sperm coincubated overnight, group B, n=1475）, short-term IVF and early rescue ICSI （shortterm ICSI, group C, n=94）, and regular ICSI （group D, n=237）. Results In group A, 69.8% （217/311） achieved normal fertilization rates, and the complete fertilization failure rate （fertilization rate was 0%） was 12.9% （40/311）. But all of the fertilization failure oocytes got rescue ICSI. In group B, the complete fertilization failure rate was 1.1% （19/1 692）. The fertilization rate, 2 PN （pronucleus） rate, and i PN rate were significantly lower in group A than those in group B （70.9% vs 80.8%, 57.8% vs 66.3%, and 3.5% vs 6.2%, respectively）. No significant differences were observed in clinical pregnancy rates and birth defect rates between groups A and B. The fertilization rates in groups C and D did not significantly differ （77.9% vs 76.2%）, which was also true for birth defect rates. The clinical pregnancy rate of group C was higher than that of group D （51.2% vs 42.3%）, but this difference was not significant （P〉0. 05）.Conclusion These results suggested that selective, short-term fertilization can result in effective outcomes for patients who were at high risk for fertilization failure.
文摘目的探讨短时授精观察联合早期补救ICSI(Intracytoplasmic sperm injection,卵胞浆内单精子注射)在受精失败高危人群中的应用结局。方法回顾性分析2016年1月至2018年12月在本院进行的短时授精周期280个,其中补救ICSI周期65个。分别比较短时授精未补救组与常规授精组,短时授精补救ICSI组与ICSI组的2PN(2Pronuleus,正常受精)、多PN(>2Pronuleus,多精受精率)、优胚率、囊胚率、受精失败率、平均可用胚胎数、低2PN率、妊娠率及活产率。结果短时授精未补救组与常规授精组,短时授精补救ICSI组与ICSI组女方平均年龄、体重指数(body mass index,BMI)、不孕年限、促性腺激素(gonadotrophin,Gn)总量、Gn天数、回收卵数比较差异均无统计学意义;短时授精未补救组低2PN率比例显著低于常规授精组(1.9%vs.6.0%),补救ICSI组囊胚形成率(51.5%vs.60.6%)显著低于ICSI组;短时授精进行补救ICSI的周期比例为23.2%,补救周期未发生受精失败,且均获得了可利用胚胎。结论短时授精联合补救ICSI助孕可有效地降低受精失败率,并可获得与常规授精及ICSI周期相似的妊娠结局。
文摘Objective To evaluate the application value of rescue ICSI in fertilization failure after conventional IVF and choose the best rescue window before oocyte aging according to the results of rescue ICSI performed in different time. Methods The data of 93 IVF cycles were analyzed retrospectively. Rescue ICSI was performed in these cycles after conventional IVF failure. Because of the different rescue time, these cycles were divided into two groups： early rescue group （group A, 77 cycles, rescue ICSI performed 4-8 h after conventional IVF） and late rescue group （group B, 16 cycles, rescue ICSI performed 20-22 h after conventional IVF）. Results There were no statistically significant differences in age of female, duration of infertility, number of oocytes retrieved every cycle. The normal fertilization rate, pregnancy rate and implantation rate were decreased in group B compared with those in group A （P〈0.05）. In group A, the normal fertilization rate of rescue ICSI performed 4-6 h after conventional IVF （group A1） was increased compared with that of rescue ICSI performed 6-8 h （including 6 h） after conventional IVF （group A2）（66.5% vs 55.9%）（P〈0.05）; while the abnormal fertilization rate in group A1 was decreased compared with group A2 （9.0% vs 14.4%）（P〈0.05）. Clinical pregnancy rate was slight higher in group A1 than in group A2, though this failed to be significantly different. Conclusion Rescue ICSI is effective if fertilization was failure after conventional IVF, the most important thing is to choose the reasonable rescue window before oocyte aging when ICSI is performed.
