IVF/ICSI中取卵后无胚胎可移植的原因探讨  

Analysis on the causes of no embryo to transfer after OPU in IVF/ICSI Causes of no embryo to transfer after ovum pick-up in in-vitro fertilization and intracytoplasmic sperm injection

作　　者：翟丹梅[1] 李柳铭 李慕军[1] 靳玉甫[1] 黄世扬[1] 覃爱平[1] 

机构地区：[1]广西医科大学第一附属医院妇产科生殖医学研究中心,南宁530021

出　　处：《妇产与遗传（电子版）》2011年第1期25-29,共5页Obstetrics-Gynecology and Genetics (Electronic Edition)

基　　金：广西卫生厅自筹经费科研课题(Z2010356);广西教育厅立项科研项目(201010LX026)

摘　　要：目的探讨取卵后无胚胎可移植的原因及应对方法,为今后类似病例助孕方式和处理方法的选择提供依据。方法对在本院生殖中心接受助孕治疗并行采卵术的无胚胎可移植的142对夫妇的原因及影响因素进行统计分析。结果 2 324个取卵周期中无胚胎可移植的周期数是146个,占取卵周期总数的6.3%(146/2 324)。146个无胚胎可移植周期中常规体外受精完全受精失败61个,占总数的41.8%(61/146),是无胚胎可移植的主要原因,而其他原因中非正常受精、取卵失败、正常受精后受精卵不分裂、正常受精胚胎质量差、ICSI完全受精失败、取精失败分别占总数的20.5%(30/146)、15.1%(22/146)、8.9%(13/146)、6.8%(10/146)、5.5%(8/146)、1.4%(2/146)。146个无胚胎可移植周期与同期有胚胎可移植周期总数比较,前者除了获卵数显著低于后者外,女方年龄、不孕年限、促性腺激素Gn天数和Gn用量均显著高于后者的(P<0.05)。结论 IVF/ICSI中取卵后无胚胎移植的原因多而复杂,其中常规IVF受精失败是其主要原因。Objectjve To analyze the reason for no embryo transfer after ovum pick-up （OPU） and its management in in-vitro fertilization and intracytoplasmic sperm injection （IVF-ICSI） cycles. Methods A total of 142 cases of no embryo to transfer after OPU in IVF-ICSI cycles were analyzed for causes of canceled embryo transfer. Results Of the total of 2324 OPU cycles, no embryo to transfer occurred in 146 cycles （6. 3% ） . Complete fertilization failure in conventional IVF contributed to no embryo to transfer in 61 cycles, accounting for 41.8% （61/146） of cycles with embryo transfer cancellation. Other reasons for no embryo to transfer included abnormal fertilization, empty follicle syndrome, failure of split of normal fertilized egg, poor quality of embryos after normal fertilization, and complete fertilization failure following ICSI, occurring at the rates of 20.5% （30/146）, 15.1% （22/146）, 8.9% （13/146）, 6. 8% （10/146）, 5.5% （8/146）, and 1.4% （2/146）, respectively. Compared with the concurrent 2178 cycles of embryo transfer, the 146 cycles with no embryo to transfer were associated with a significantly lower retrieved oocytes number, greater woman age, longer infertility duration and Gn days, and greater total Gn doses （ P 〈 0. 05 ） Conclusion Embryo transfer cancellation after OPU in IVF/ICSI has complex causes, among which conventional IVF fertilization failure plays a dominant role.

关 键 词：受精 体外 精子注射 细胞质内 胚胎移植 卵泡 

分 类 号：R714.8[医药卫生—妇产科学]