短时受精失败后补行ICSI的实验室指标和新生儿情况分析  

The laboratory parameters and neonatal conditions of rescued-ICSI

作　　者：孟祥黔[1] 曾咏梅[1] 黄军[1] 黄继华[1] 李莹星[1] 周健明[1] 雷平[1] 黄渝鸿[1] 毛如荣 钟影[1] 

机构地区：[1]成都市锦江区妇幼保健院生殖医学中心,四川成都610016

出　　处：《癌变．畸变．突变》2014年第1期63-67,共5页Carcinogenesis,Teratogenesis & Mutagenesis

基　　金：四川省科技厅基础医学研究项目(2012JY0066)

摘　　要：目的:探讨常规体外受精(IVF)失败后补行卵胞浆内单精子显微注射(ICSI)的实验室指标和新生儿情况。方法:回顾性分析2011年1-12月在成都锦江妇幼保健院接受ICSI治疗的患者203例(对照组)和IVF失败后补行ICSI的患者117例(实验组)的实验室检查结果、临床数据和新生儿情况。结果:实验组患者多精受精率(3.00%)显著高于对照组(1.39%)(P<0.05)。对照组中有1例引产,1例早产儿在产后10 d夭折。实验组与对照组的正常受精率、卵裂率、D3优胚率、囊胚形成率、冷冻周期率、移植周期率、胚胎着床率、妊娠率、多胎妊娠率、异位妊娠率、早期流产率、晚期流产率、活胎分娩率以及胎儿畸形率差异均无统计学意义(P>0.05)。新生儿情况对比发现,两组间婴儿性别比、身长、体质量、Apgar评分差异亦无统计学意义(P>0.05)。单、双胎妊娠新生儿中,实验组孕周、体质量、身长和Apgar评分与对照组比较差异均无统计学意义。结论:常规IVF受精失败后,及时补行ICSI能显著提高受精率和优胚率,进而改善临床结局。OBJECTIVE： To investigate laboratory parameters and neonatal conditions of rescued ICSI. METHODS：Laboratory tests,obstetric manifestations and neonatal outcomes of 203 couples receiving conventional ICSI （control group） were compared to those of 117 couples receiving rescued ICSI （test group） by using retrospective study at Chengdu Jinjiang Hospital for Maternal and Child Health Care from January to December 2011. RESULTS：Incidence of multiple pronucleates in test group （3.00%） was significantly higher than that in control （1.39%）. A patient had induced abortion and a premature baby died on the 10th day after birth in control group. There were no differences in rates of fertilization,cleavage,D3 top quality embryo,blastocyst formation,cryopreservation,embryo transfer,implan-tation, pregnancy,multiple-gestation pregnancy,ectopic pregnancy,early abortion,late abortion, live-born and fetal malformation between test and control groups. Neonatal outcome measures also showed no statistical difference in sex ratio,newborn＆#39;s length and weight at birth and Apgar score betweengroups. For singleton pregnancies,preterm birth rate （8.33%） in control group was lower than that in test group （20.51%）,and for twin pregnancies,preterm birth rate （63.64%） in control group was higher than that in test group （25.00%）,but no significant difference for either singleton or for twin pregnancies between groups was observed. CONCLUSION：ICSI after a previous failed fertilization of conventional IVF may significantly improve the fertilization rate ,high-quality embryo and clinical outcomes of a second IVF-ET cycle.

关 键 词：体外受精 卵胞浆内单精子显微注射 新生儿 胚胎 

分 类 号：R713.7[医药卫生—妇产科学]