ICSI术改善前次IVF周期中多精受精的有效性研究  

Effectiveness of ICSI in patients with a high incidence of triploidy in a previous IVF cycle

作　　者：徐志鹏[1] 孙海翔[1] 胡娅莉[1] 张宁媛[1] 陈林君[1] 王玢[1] 赵静[1] 蒋益群[1] 曾惠明[1] 

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,江苏南京210008

出　　处：《中华男科学杂志》2011年第11期973-976,共4页National Journal of Andrology

基　　金：国家自然科学基金(3081070492)~~

摘　　要：目的:探索ICSI术改善前次IVF周期中多精受精的有效性。方法:回顾性分析本中心2008年4月至2011年4月共37例患者,其IVF周期三原核合子的比例高于35%,重复周期采用ICSI术治疗。比较ICSI周期与IVF周期的双原核率、三原核率、正常胚胎数、移植周期临床妊娠率及胚胎种植率。结果:ICSI周期患者年龄显著高于IVF周期,而促性腺激素使用剂量、E2值与IVF周期无显著差异,ICSI周期hCG注射日卵泡数(≥14 mm)、获卵数及成熟卵子数均显著低于IVF周期。ICSI后双原核的比例显著高于IVF周期(74.24%vs34.42%;P<0.01),而三原核的比例显著低于IVF周期(11.57%vs 51.04%;P<0.01)。ICSI后获得正常胚胎数显著高于IVF组(3.83±2.08 vs 2.52±1.71;P<0.01)。IVF周期移植31例,4例妊娠,均为单胎。ICSI周期移植36例,14例妊娠,其中3例双胎,11例单胎。ICSI周期临床妊娠率及胚胎种植率均显著高于IVF周期(38.89%vs12.90%;28.33%vs 7.41%;P均<0.01)。结论:对于前次IVF多精受精比例较高的患者,重复周期采用ICSI术可以增加正常受精胚胎数,能有效改善重复周期患者多精受精的发生。Objective： To explore the effectiveness of ICSI in overcoming the high incidence of tripronucleates zygotes resulting from insemination in a previous IVF cycle.Methods： We retrospectively analyzed the matched-pair cycles in 37 patients with a 35 % incidence of tripronucleate zygotes in an IVF cycle,with ICSI used in the subsequent cycle,evaluated the incidences of diploid（2PN） and triploid（3PN） zygotes and the number of normal embryos obtained,and compared the rates of clinical pregnancy and embryo implantation between the IVF and ICSI groups.Results： The mean age of the ICSI group was significantly older than that of the IVF group,while the ampules of gonadotropin and peak E2 showed no remarkable difference between the two.The numbers of follicles at hCG trigger,retrieved oocytes and mature oocytes were markedly lower in the former than in the latter.The percentage of 2PN was significantly higher while that of 3PN significantly lower after ICSI than after IVF（74.24% vs 34.42%;11.57% vs 51.04%,P0.01）,and more normal diploid embryos were obtained with ICSI（3.83±2.08 vs 2.52±1.71,P0.01）.Four sigletons were achieved in 31 IVF embryo transfer cycles,in comparison with 11 sigletons and 3 twins in 36 ICSI embryo transfer cycles.The ICSI group showed significantly higher rates of clinical pregnancy and embryo implantation than the IVF group（38.89% vs 12.90%;28.33% vs 7.41%,P0.01）.Conclusion： For women with a high incidence of triploidy in a previous IVF cycle,ICSI can effectively increase the number of normal diploid zygotes.

关 键 词：卵细胞胞质内单精子注射 体外受精 多精 胚胎 辅助生殖技术 

分 类 号：R714.8[医药卫生—妇产科学]