同周期同胞卵实施卵胞浆内单精子注射和常规体外受精增加受孕机会  

Increased pregnant chance by conventional IVF and ICSI of sibling oocytes

作　　者：张凤英[1] 张云山[1] 高企贤[1] 张莹[1] 张美姿[1] 王小茹[1] 李媛[1] 

机构地区：[1]天津市中心妇产科医院生殖与助孕研究中心,天津300052

出　　处：《第四军医大学学报》2004年第15期1429-1431,共3页Journal of the Fourth Military Medical University

摘　　要：目的 :比较分析同周期同胞卵分别实施常规体外受精 (IVF)和卵胞浆内单精子注射 (ICSI)的结果和临床预后 .方法 :选择我中心实施体外受精 胚胎移植中的 4 3个治疗周期 ,将同周期同胞卵分成IVF组和ICSI组 ,使用相同的精液标本分别实施IVF和ICSI (IVF +ICSI) ,进行比较分析 .结果 :ICSI组受精率为 6 4 .5 % ,高于IVF组 5 2 .8%的受精率 (P <0 .0 1 ) ;完全受精失败的IVF组占 1 1 .6 % ,而ICSI组无一例完全受精失败 ;ICSI组的优良胚胎率为 6 0 .8% ,显著高于IVF组 30 .1 % (P <0 .0 1 ) ;卵裂率分别为 97.1 %和96 .7% ,无统计学意义 (P >0 .0 5 ) ;用于移植的胚胎数ICSI组为 1 2 0个占总移植胚胎数的 6 3.5 % ,IVF组为 6 9个占36 .5 % ;IVF +ICSI总的植入率 1 7.5 % ,显著高于同期单纯实施IVF 1 0 .4 %和单纯实施ICSI 9.8% (P <0 .0 1 ) ;取卵周期临床妊娠率同我中心同期单纯实施IVF和单纯实施ICSI比较 ,具有统计学意义 (P <0 .0 1 ) ,分别为 4 1 .9% ,2 6 .2 %和 2 8.1 % ;抱婴回家率为 77.8% .结论 :同周期同胞卵分别实施常规IVF和ICSI总体上能改善胚胎质量增加受孕机会并提高临床妊娠率 .AIM: To compare and analyze the result and the clinical outcome in sibling oocytes treated by conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). METHODS: Sibling oocyte cumulus complexes (OCC) of 43 different couples were divided into two groups: IVF group and ICSI group, using the same semen sample and inseminated respectively by IVF and by ICSI (IVF+ICSI). RESULTS: In ICSI group, a total of 282 MⅡ oocytes yielded a diploid fertilization rate of 64.5%, significantly higher than that of 52.8% in the IVF group with 265 oocytes ( P <0.01). Complete fertilization failure was 11.6% in IVF group but none in the ICSI group, and there was significant difference in the good quality embryo rates between the IVF group (30.1%) and the ICSI group (60.8%) ( P <0.01). The total cleavage rates in both IVF and ICSI groups were quite similar: 96.7% and 97.1% respectively ( P <0.05). The best embryos were selected for transfer in a total of 189 embryos and of the transferred embryos, 120 embryos were in the ICSI group (63.5%) and 69 in the IVF group (36.5%). The implantation rate and clinical pregnancy rate of the sibling oocytes of IVF and ICSI (IVF+ICSI) versus independent IVF or independent ICSI were 17.5%, 10.4%, 9.8% and 41.9%, 26.2%, 28.1% respectively, which were significantly different. The take home baby rate was 77.8%. CONCLUSION: The insemination procedure of sibling oocytes by IVF and by ICSI may improve the embryo quality and increase the pregnant chance and clinical pregnant rate.

关 键 词：ICSI IVF 受精率 临床妊娠率 植入率 同胞卵 完全受精失败 

分 类 号：R394[医药卫生—医学遗传学]