辅助生殖技术中原因不明性不孕患者的病因分析  

Etiological analysis on patients with unexplained infertility in assisted reproductive technology

作　　者：关如意[1] 史中娜[1] 任新玲[1] 刘群[1] 陈雯[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院生殖中心,湖北武汉430030

出　　处：《中国妇幼保健》2013年第32期5324-5327,共4页Maternal and Child Health Care of China

摘　　要：目的：借助于辅助生殖技术，进一步明确“原因不明性不孕”患者的病因。方法：回顾性分析2011年1～12月在华中科技大学附属同济医院生殖中心行体外受精胚胎移植（IVF—ET）和卵母细胞胞浆内单精子注射术（ICSI）的原因不明性不孕患者54例和单纯输卵管梗阻患者244例，比较两组受精情况、胚胎发育潜能、临床结局及卵母细胞异常形态比例之间有无差异。结果：两组在年龄、不孕年限、基础窦卵泡数和平均获卵数上均有统计学差异（P=0．000）。不明原因患者受精率较输卵管患者低，差异有统计学意义（57．93％vs62．72％，P〈0．05）。不明原因组补救ICSI率明显高于输卵管梗阻组（25．00％vs6．07％，P=0．000）。不明原因患者的卵母细胞异常形态率显著高于输卵管梗阻组（18．15％vs8．68％，P=0．000）。两组优胚率、可利用囊胚率、种植率和临床妊娠率均无统计学差异（P〉0．05）。结论：精卯结合障碍和卵母细胞形态异常可能是不明原因性不孕患者潜在的不孕因素。Objective： To further definite the causes of patients with unexplained infertility by means of assisted reproductive tech- nology （ART） . Methods： A total of 54 patients with unexplained infertility and 244 patients with oviduct obstruction who received in vitro fertilization - embryo transfer （ IVF - ET） and intracytoplasmic sperm injection （ICSI） respectively in the hospital from January 2011 to De- cember 2012 were analyzed retrospectively; the fertilization conditions, embryo development potentials, clinical outcomes, and proportions of ooeytes with abnormal shape in the two groups were compared. Results： There were statistically significant differences in the age, duration time of infertility, basic antral follicular count, and mean number of retrieved oocytes between the two groups （ P = 0. 000） . The fertilization rate in unexplained infertility group （57.93%） was statistically significantly lower than that in oviduct obstruction group （62.72%） （P 〈 0. 05 ） . The rescue ICSI rate in unexplained infertility group （ 25.00% ） was statistically significantly higher than that in oviduct obstruction group （6.07%） （P =0. 000） . The proportion of ooeytes with abnormal shape in unexplained infertility group （ 18.15% ） was statistically significantly higher than that in oviduct obstruction group （8.68%） （P = 0. 000） . There was no statistically significant difference in high quality embryo rate, available blastosphere rate, implantation rate, and clinical pregnancy rate between the two groups （P 〉 0. 05 ） . Con- dusion： Defective sperm - egg binding and abnormal oocytes appearance may be the potential factors of unexplained infertility.

关 键 词：不明原因不孕 补救ICSI 精卵结合障碍 卵细胞形态异常 

分 类 号：R711.6[医药卫生—妇产科学]