透明带形态异常卵母细胞在IVF完全受精失败后行补救ICSI的临床结局  

Clinical Outcome of Abnormal Morphology Zona Pellucida Oocytes with Rescue ICSI in Total Fertilization Failure after IVF Cycle

作　　者：刘晓妍[1] 张守信[2] 郝翠芳[1] 单英华[1] 沈肖方[1] 黄鑫[1] 陈丽丽[1] 张玉花[1] 

机构地区：[1]烟台毓璜顶医院生殖医学中心,烟台264000 [2]烟台毓璜顶医院生物芯片实验室,烟台264000

出　　处：《生殖与避孕》2012年第11期754-759,共6页Reproduction and Contraception

基　　金：国家自然基金面上项目;项目号:81170622

摘　　要：目的:研究透明带形态异常卵母细胞的受精、胚胎发育和临床结局。方法:以在IVF完全受精失败(TFF)周期中透明带形态异常的15名患者为研究组(A组),非透明带形态异常的完全受精失败周期的63例患者为对照组(B组),回顾性分析比较患者的一般临床情况、IVF结局及行补救ICSI(R-ICSI)的临床结局。结果:除受精率组间有显著性差异(65.52%vs 78.86%,P<0.01)外,其余各指标(年龄、不孕年限、不孕类型、不孕原因、基础内分泌水平、基础卵泡数、降调节天数、Gn使用天数、Gn使用总量、hCG注射日直径≥16 mm卵泡数、hCG注射日E2、P和LH水平、获卵数、MII卵数、行R-ICSI的受精率、卵裂率、优质胚胎率、种植率、临床妊娠率和流产率)组间均无统计学差异。结论:IVF完全受精失败周期透明带形态异常卵母细胞行R-ICSI虽受精率较低,但及早发现受精失败并行R-ICSI,可使65.52%的卵子受精,从而改善临床结局。Objective： To identify the fertilization, embryo growth and clinical results of patients with oocytes zona pellucida abnormalities who received rescue intracytoplasmic sperm injection （R-ICSI）. Methods： Fifteen patients with abnormal morphology zona pellucida oocytes （group A） and 63 patients with normal morphology zona pellucida oocytes （group B） who received R-ICSI aRer total fertilization failures （TFF） were included in the study. Patients＇ age, infertility duration, infertility type, infertility reason, basal endocrine, basal egg follicle numbers, down regulation days, Gn used days, Gn dosage, numbers of egg follicle with diameter≥16 mm, E2, P, LH level on hCG injection day, retrieved oocyte numbers, metaphase Ⅱ oocyte numbers, the fertilization rate with early R-ICSI, embryo cleavage rate, good-quality embryo rate, embryo implantation rate, clinical pregnancy rate and abortion rate were compared between the two groups. Results： There was no statistical difference between group A and group B in TFF in all factors, except fertilization rate （65.52% vs 78.86%, P〈0.01）. Conclusion： Abnormal morphology zona pellucida oocytes with R-ICSI may result in low fertilization rate in TFF. R-ICSI can fred and rescue fertilization failure timely and get better clinical outcome.

关 键 词：透明带(ZP) 完全受精失败(TFF) 体外授精-胚胎移植(IVF-ET) 补救性ICSI(R-ICSI) 

分 类 号：R714.8[医药卫生—妇产科学]