不同指征患者卵胞浆内单精子注射治疗后临床结局的比较  

Clinical outcome analysis in ICSI patients with different indications

作　　者：刘巧斌[1] 纪红[1] 陈媛媛[1] 任建枝[1] 

机构地区：[1]解放军第一七四医院生殖中心,福建厦门361003

出　　处：《中国医药导报》2013年第32期51-53,共3页China Medical Herald

基　　金：福建省厦门市重大科技创新平台项目(编号3502Z20111006)

摘　　要：目的 比较不同指征患者采用卵胞浆内单精子注射（ICSI）治疗后胚胎质量及临床结局.方法 选择2009年1月～2011年12月解放军第一七四医院生殖中心采取ICSI方式助孕治疗的患者620例.按病因分为3组,A组150例为因无精子症原因行ICSI术的患者;B组416例为由于重度少弱精子症原因行ICSI术的患者;C组54例为由于受精障碍、低受精原因行ICSI术的患者.比较各组年龄、体重指数、不孕年限、卵子受精、胚胎卵裂、优质胚胎、临床妊娠和活产情况.结果 ①三组患者年龄和体重指数差异有统计学意义（P＜0.05）;A组患者年龄和体重指数均明显小于其B、C组,B组年龄小于C组,差异有统计学意义（P＜0.05）;不孕年限三组间差异无统计学意义（P＞0.05）.②A组患者受精率[73.49％（1156/1573）]低于B、C组[76.25％ （3008/3945）、78.47％（339/432）],差异有统计学意义（P＜0.05）.胚胎卵裂率和优质胚胎率,三组间比较差异无统计学意义（P＞0.05）.③A组妊娠率[62.0％ （93/150）]和活产率[53.33％ （80/150）]均显著高于B组[48.8％ （203/416）、39.66％（165/416）]及C组[48.2％（26/54）、38.89％ （21/54）],差异均有统计学意义（P＜0.05）.结论 不同指征患者ICSI术后导致了受精情况的显著差异,但受精后各组之间的胚胎情况相似,女性年龄是影响临床结局的重要因素.Objective To compare the embryo quality and clinical outcome between patients of different indications with intracytoplasmic sperm injection.Methods 620 cases with assisted reproduction of ICSI in Department of Reproductive Medicine Center,174th Hospital of PLA from January 2009 to December 2011 were selected and divided into 3 groups according to pathogenesis.150 cases with severe azoospermatism of ICSI were distributed to group A; 416 cases with oligoasthenozoospermia of ICSI were assigned to group B; 54 cases with fertilization obstacles or low fertilization reason of ICSI distributed to group C.The age,body mass index,duration of infertility,fertilization rate,cleavage rate,good-quality embryo rate,clinical pregnant rate and live birth rate were observed.Results ①The differences of age and BMI among the 3 groups were statistically significant （P ＜ 0.05）; the ages and BMI of group A were lower than those of group B and group C,the age of group B was lower than that of group C,the differences were statistically significant （P ＜ 0.05）; the difference of infertility year among 3 groups was not statistically significant （P ＞ 0.05）.②Fertility rate of group A [73.49％ （1156/1573）] was lower than that of group B and group C [76.25％ （3008/3945）,78.47％ （339/432）],the differences were statistically significant （P ＜0.05）.The differences of embryo cleavage rate and high quality embryo rate among the 3 groups were not statistically significant （P ＞ 0.05）.③Pregnancy rate [62.0％ （93/150）] and live birth rate [53.33％ （80/150）] of group A were all higher than those of group B [48.8％ （203/416）,39.66％ （165/416）] and group C [48.2％ （26/54）,38.89％ （21/54）],the differences were statistically significant （P ＜ 0.05）.Conclusion The analysis shows that different indications of patients lead to significant difference in fertilization rate; however,there is no difference in embryo quality after fertilization.Female age is a major factor affecti

关 键 词：无精子症 重度少弱精子症 受精障碍 ICSI术 

分 类 号：R698[医药卫生—泌尿科学]