获单卵周期行体外受精/卵胞质内单精子显微注射的结局比较  

Study on application effect of in vitro fertilization/intracytoplasmic sperm injection in one egg cycle

作　　者：杜元杰[1] 邵小光 王秀霞[3] 任海琴 武学清 郭帅帅[6] 张云山[7] 赵志明[1] Du Yuanjie;Shao Xiaoguang;Wang Xiuxia;Ren Haiqin;Wu Xueqing;Guo Shuaishuai;Zhang Yunshan;Zhao Zhiming(The Second Hostipal of Hebei Medical University,Shijiazhuang 050000,China;Dalian Municipal Women and Children's Medical Center,Dalian 116037,China;Shengjing Hospital of China Medical University,Shenyang 110004,China;Shenyang Dongfang Jinghua Hospital,Shenyang 110005,China;Center of Reproductive Medicine,Children's Hospital of Shanxi and Women Health Center of Shanxi,Taiyuan 030013,China;Shenyang Women's and Children 's Hospital,Shenyang 110010,China;Tianjin Central Hospital of Gynaecology and Obstetrics,Tianjin 300100,China)

机构地区：[1]河北医科大学第二医院,石家庄050000 [2]大连市妇女儿童医疗中心,116037 [3]中国医科大学附属盛京医院,沈阳110004 [4]沈阳东方菁华医院,110005 [5]山西省儿童医院山西省妇幼保健院生殖医学中心,太原030013 [6]沈阳市妇婴医院,110010 [7]天津市中心妇产科医院,300100

出　　处：《中华生殖与避孕杂志》2019年第1期5-9,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的 探讨不孕患者获1枚卵周期合理的授精方式的选择。 方法 对2014年1月—2015年12月期间在大连市妇女儿童医疗中心、山西省儿童医院山西省妇幼保健院生殖医学中心、沈阳东方菁华医院、沈阳市妇婴医院、中国医科大学附属盛京医院、天津市中心妇产科医院和河北医科大学第二医院生殖医学科因女方因素不孕行助孕治疗且获卵数为1枚的965例不孕症患者共计965个治疗周期临床资料进行回顾性队列分析。根据不同授精方式分为体外受精(IVF)组(675个周期)和卵胞质内单精子显微注射(ICSI)组(290个周期)。比较IVF组和ICSI组患者的一般资料、受精率、胚胎发育情况和临床妊娠结局。 结果 IVF组多原核(PN)率(7.11%)、多PN总比率(7.11%)均明显高于ICSI组(1.48%,1.38%),差异具有统计学意义(P<0.01)。IVF组移植周期率(34.22%)明显高于ICSI组(24.48%),差异具有统计学意义(P<0.01)。IVF组可移植周期率和可利用胚胎率略高于ICSI组,但差异无统计学意义(P>0.05)。临床妊娠率、周期妊娠率和胚胎种植率组间比较差异均无统计学意义(P>0.05);IVF组流产率(15.38%)略低于ICSI组(41.67%)(P=0.05)。 结论 在仅有1枚卵细胞的治疗周期中,ICSI授精并不能提高临床妊娠率、改善妊娠结局,IVF授精是一种安全有效、又降低治疗成本的方式,值得临床推广应用。Objective To provide a clinical basis for selecting a reasonable fertilization method for infertile patients with one egg in the future. Methods A retrospective cohort study was conducted in Dalian Municipal Women and Children’s Medical Center, Center of Reproductive Medicine, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Shenyang Dongfang Jinghua Hospital, Shenyang Women’s and Children’s Hospital, Shengjing Hospital of China Medical University, Tianjin Central Hospital of Gynaecology and Obstetrics and the Second Hospital of Hebei Medical University from January 2014 to December 2015. A total of 965 infertility patients who were assisted by fertility medicine and got one egg were divided into in vitro fertilization (IVF) group (n=675) and intracytoplasmic sperm injection (ICSI) group (n=290) according to different insemination methods. The general data, fertilization rate, embryonic development and clinical pregnancy outcomes were compared between the two groups. Results The multiple pronucleus (PN) rate and multiple PN rate of all eggs in IVF group (7.11%, 7.11%) were significantly higher than those in ICSI group (1.48%, 1.38%) (P<0.01). The rate of embryo transfer cycle in IVF group (34.22%) was significantly higher than that in ICSI group (24.48%) (P<0.01). The IVF group had higher rates of transplantable cycles and available embryos than ICSI group, but there was no significant difference. There was no significant difference in clinical pregnancy rate, cycle pregnancy rate and embryo implantation rate between the two groups (P>0.05). The IVF group (15.38%) had a slightly lower miscarriage rate than ICSI group (41.67%), but the difference was not statistically significant (P=0.05). Conclusion ICSI insemination can not improve clinical pregnancy rate or pregnancy outcomes during the treatment cycle of only one egg. Therefore, IVF insemination is a safe and effective way to reduce the cost of treatment, which is worthy of clinical application.

关 键 词：受精 体外 精子注射 细胞质内 生殖技术 辅助 1枚获卵周期 低获卵周期 

分 类 号：R714.8[医药卫生—妇产科学]