常规IVF受精失败补救ICSI后行冻融胚胎移植的临床价值  

Clinical value of frozen-thawed embryo transfer of intracytoplasmic sperm injection for patients with fertilization failure in conventional in vitro fertilization

作　　者：倪丰[1] 姜宏[1] 何瑞冰[1] 汪存利[1] 张文香[1] 

机构地区：[1]解放军第105医院生殖医学中心,合肥230032

出　　处：《中国优生与遗传杂志》2012年第2期103-104,共2页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨冻融胚胎移植在常规体外受精(IVF)失败后补救卵胞浆内单精子注射(L-ICSI)中的应用价值。方法在12个常规体外受精失败周期中应用ICSI对未受精的MⅡ期卵子进行显微授精,将获得的优质胚胎进行冷冻,再择期行冻融胚胎移植。结果对93个未受精的MⅡ卵子接受L-ICSI,受精63枚,受精率为67.7%(63/93),异常受精3枚(2枚1PN,1枚3PN),57个正常受精卵发生卵裂,卵裂率为95.0%(57/60),优质胚胎率为43.9%(25/57),10例患者冷冻胚胎25枚,其中4例采用程序化冷冻,6例采用玻璃化冷冻。9个患者行冻融胚胎移植,共移植胚胎18枚(其中解冻后胚胎碎裂死亡5枚),其中1个周期因冻融后2个胚胎碎裂放弃移植,2例获得临床妊娠,1例分娩出正常婴儿,1例正在妊娠中,临床妊娠率为22.2%。结论 ICSI可使常规体外受精失败的卵子再受精,冻融胚胎移植可以解决胚胎与子宫内膜不同步的问题,获得相对满意的临床结局,具有一定的应用价值。Objective ： To evaluate the clinical value of frozen - thawed embryo transfer of intracytoplasmic sperm injection （ IC- SI） for rescuing of conventional in vitro fertilization （IVF） failure. Methods ： 93 unfertilized M 1I oocytes in 12 women with conventional IVF failure were performed rescue ICSI （Late ICSI） at 18 hours after conventiona fertiliazation in our center, then good quality embryos were frozen and transferred after thawing three monthes later. Results ： 63 oocytes out of 93 unfertilized M II ooeytes were fertilized after Late ICSI, the rates of fertilization, cleavag and good - quality embryo were 67. 7% （63/93） , 95.0% （57/60） and 43.9% （25/57）, respectively, three abnormal fertilization was observed out of 63 fertilized egg （two with mono -pronueleus, one with three pronuelei）. 25 good quality embryos were cryopreserved by the methods of vitrification in six patients and slow- freezing in other four patients. Eighteen embryos were transferred into uterine cavity in nine women after thawing, one patient failed to receive embroy transfer due to poor quality embryos after thawing. Two patients had documented clinical pregnancies with 22. 2% （2/9） clini- cal pregnancy rate per ET, one had given a healthy live birth by uterine -incision, the other has ongoing pregnancy at the 14th week （？）. Conclusion ： Late ICSI could be used to reinseminate unfertilized M 11 oocytes in fertilization failure IVF cycles, freezing - thawing embryo transfer from Late ICSI could reduce cycle cancellation rate per ooeyte retrieval and obtain a relative satisfactory clinical pregnancy rate by synchronizing embryo development and endometrial receptivity.

关 键 词：受精失败 补救ICSI 冷冻保存 冻融胚胎 子宫内膜 

分 类 号：R714.8[医药卫生—妇产科学]