部分卵子卵胞浆内单精子注射在辅助生殖技术中的应用价值  

Value of Half Intracytoplasmic Sperm Injection in Assisted Reproductive Techniques

作　　者：张译升[1] 康亚男[1] 刘冬娥[1] 李玉梅[1] 李艳萍[1] 刘能辉[1] 陈仙花[2] 姚仲元 周世敏[2] 张叶青[2] 邓丽萍(编辑)[1] 

机构地区：[1]中南大学湘雅医院生殖中心,湖南长沙,410008 [2]中国医学遗传学国家重点实验室,湖南 长沙,410008

出　　处：《医学临床研究》2012年第8期1428-1431,共4页Journal of Clinical Research

摘　　要：【目的】探讨部分卵子卵胞浆内单精子注射（half-ICSI）指征的选择及其在辅助生殖技术中挽救受精失败的意义。【方法】回顾性分析2007年1月至2008年12月在本院生殖中心实施采卵周期的常规体外受精（IVF）及halPICSI患者的临床资料，比较两种方法的临床特征、受精率及妊娠率。【结果]hal{-ICSI组在不孕年限、不孕年限大于10年、原发性不孕及男方轻中度少弱畸精子症所占比例显著高于IVF组（P〈0.05）；halPICSI组低受精率及完全受精失败率较IVF组明显增高（P〈O．05），但Half—ICSI组中低受精组的妊娠率与常规IVF妊娠率相比差异无统计学意义（P〉0．05）；half-ICSI组内IVF、ICSI均受精组各项精液参数均高于仅ICSI受精组，但仅在处理前精子总活率、处理前A级精子、处理前B级精子、处理后B级精子百分率上差异有统计学意义（P〈O．05）；half-ICSI中根据移植胚胎来源分为IVF组、IVF＋ICSI及ICSI组，以移植IVF＋ICSI混合胚胎的着床率及妊娠率为最高，差异有统计学意义（P〈0．05）。【结论】对于原发性不孕、不孕年限大于10年、男方轻中度少弱畸精子症的患者，无论是单项或合并多项明确不孕原因存在可疑受精障碍，可考虑行halMCSI治疗，避免完全受精失败及妊娠率低下。[Objective]To explore the clinical indications of half intracytoplasmic sperm injection（half-IC- SI） and its significance in saving the fertilization failure of assisted reproductive technology. [Methods] Clini- cal data of patients undergoing conventional in vitro fertilization（IVF） or half-ICSI during ovum collection cycle in our hospital from Jan. 2007 to Dec. 2008 were analyzed retrospectively. Clinical characteristics, fertilization rate and pregnancy rate were compared between two methods. [Results]The infertility duration, the constitu- ent ratio of infertility for more than 10 years, primary infertility and male mild-to-moderate oligospermatism or teratozoospermia infertility in half-ICSI group were significantly higher than those in IVF group（ P d0.05）. Compared with IVF group, low fertilization rate and complete fertilization failure rate in half-ICSI group obvi- ously increased. There was no significant difference in pregnancy rate between low fertilization subgroup of half-ICSI group and conventional IVF group. Semen parameters in IVF-[-ICSI fertilization subgroup of half-IC- SI group were higher than those in only ICSI fertilization group. There were significant differences in sperm survival rate before treatment and sperm percentage of grade A and B sperm before treatment and grade 13 sperm after treatment（ P d0.05）. According to the source of transplanted embryo, half-ICSI group was di- vided into IVF group, IVF＋ICSI group and ICSI group. The implantation rate and pregnancy rate of IVF^- ICSI embryo were the highest, and there was significant difference among groups（ P d0.05）. [Conclusion] Patients with primary infertility, infertility duration more than 10 years or male mild-to-moderate oligosperma- tism or teratozoospermia infertility who have suspected dysfunction confirmed by one or more indicators should received half-ICSI therapy to avoid complete fertilization failure and low pregnancy rate.

关 键 词：不育/治疗 胚泡移植 精子 

分 类 号：R321.3[医药卫生—人体解剖和组织胚胎学]