同一取卵周期采用IVF结合ICSI治疗的临床结局分析  

In vitro fertilization versus intracytoplasmic sperm injection for primary and secondary infertility using sibling oocytes:clinical analysis of the outcomes

作　　者：施晓鋆[1,2] 伍芳蓉[1] 陈士岭[1] 王庆玲[1] 罗琛[1] 倪运萍[1] 郑海燕[1] 邱卓琳[1] 张为青[1] 杨杰[1] 陈薪[1] 

机构地区：[1]南方医科大学南方医院妇产科生殖医学中心,广东广州510515 [2]贵阳市妇幼保健院,贵州贵阳550003

出　　处：《南方医科大学学报》2010年第10期2263-2266,共4页Journal of Southern Medical University

基　　金：国家重点基础研究发展规划课题(973课题)(2007CB948104)~~

摘　　要：目的探讨同期卵子采用IVF结合ICSI治疗原发性不孕症和继发性不孕症的临床价值及ICSI技术的安全性。方法 2003年1月～2008年12月在南方医院生殖医学中心接受IVF结合ICSI治疗的不孕患者149例,将同期卵子按各50%的比例随机分为两组,分别采用IVF和ICSI进行授精,比较原发性不孕症组与继发性不孕症组、IVF与ICSI组之间受精情况、临床结局及出生缺陷的差异。结果原发性不孕症组的常规IVF完全未受精率10.2%,高于继发性不孕症组3.9%(P<0.05)有显著差异。ICSI组未出现受精失败;且正常受精率及优质胚胎率高于常规IVF,多原核受精率低于IVF组(P<0.05)。ICSI组来源胚胎的着床率、临床妊娠率及分娩率高于常规IVF胚胎移植组及IVF与ICSI混合胚胎移植组,差异无统计学意义。结论长期不孕原发性不孕患者及可疑受精障碍患者宜选用IVF结合ICSI的授精方案,可获得较好的临床结局,对这类患者ICSI可能并不增加其子代的出生缺陷率。Objective To evaluate the clinical outcomes of intracytoplasmic sperm injection（ICSI） and conventional in vitro fertilization（IVF） using sibling oocytes for treatment of primary and secondary infertility.Methods A total of 149 cycles of IVF and ICSI were conducted between January,2003 and December,2008 in our center,including 98 cycles in patients with primary infertility and 51 in those with secondary infertility.According to the embryos derived from ICSI,IVF and their combination,the clinical pregnancy rate,delivery rate and birth defect of the 3 groups were analyzed.Results The fertilization failure rate of IVF was significantly higher in primary infertility group than in secondary infertility group（10.2%vs 3.9%,P0.05）.No fertilization failure occurred in ICSI group.The fertilization rates and good quality embryo rates in ICSI group were significant higher than those in IVF group,and the abnormal fertilization rate was significantly lower in ICSI group（P0.05）.No significant difference were found in the implantation rates,clinical pregnancy rates,delivery rates orthe rates of birth defects of the offsprings between IVF,ICSI and IVF＋ICSI groups.Conclusion IVF combined with ICSI may result in increased fertilization rate and avoid total fertilization failure with favorable clinical outcomes in patients with long-term infertility,and ICSI may not increase the birth defects of the offspring in these patients.

关 键 词：体外受精 胚胎移植 卵胞浆内单精子注射 出生缺陷 

分 类 号：R714.8[医药卫生—妇产科学]