不同类型不明原因不孕患者的体外受精-胚胎移植助孕结局探讨  

Investigation of outcome of IVF-ET conducted in couples with different unexplained infertility

作　　者：邓华丽[1] 叶虹[1] 陈巧莉[1] 裴莉[1] 曾品鸿[1] 黄国宁[1] 

机构地区：[1]重庆市妇幼保健院遗传与生殖研究所,400013

出　　处：《中国优生与遗传杂志》2014年第9期154-158,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的:探讨不同类型不明原因不孕(UI)夫妇接受IVF-ET助孕治疗的结局。方法:共纳入212个因UI接受IVFET助孕的周期进行回顾性分析。所有周期均采用短时受精,在IVF受精后6h,对低受精率(<30%)和IVF完全受精失败周期中未出现第二极体的成熟卵立即进行早期补救ICSI。结局按原发不孕(A1组,139例)及继发不孕(A2,组73例)分组进行比较。并将所有获得成熟卵的周期再分为IVF受精(B1组,181例)与补救ICSI受精(B2组,26例)进行比较。结果:1.A1组较A2组年轻,但不孕年限更长,MII卵IVF受精率及2PN受精率较低,补救ICSI受精周期率明显较高(17.04%比4.17%,P值<0.05)。A1组因异常受精、未受精、未卵裂或胚胎质量差导致的无可移植胚胎周期取消率明显高于A2组(11.79%比2.74%,P值<0.05),但两组移植周期种植率、临床妊娠率及活产率无显著差异(P值>0.05)。2.B1组比B2组MII卵受精率更高(93.82%比84.78%,P值<0.05),但其余指标比较无显著差异。结论:不明原因不孕夫妇中原发不孕者更容易出现IVF受精失败或低受精率。采用短时受精及补救ICSI受精后可以获得与继发不孕夫妇相当的IVF-ET临床结局。Objective： To investigate the outcome of IVF-ET conducted in couples with different unexplained infertility. Methods： A total of 212 IVF-ET cycles with different unexplained infertility accepted short-time fertilization and were recruited to analyze retrospectively. Ooeytes failed to extrude Pb2 were applied early rescue-ICSI in the cycles with low fertilization rate or completely failed fertilization after 6h sperms and oocytes incubation. IVF-ET outcomes of couples with primary （group A1, 139 cycles） or secondary （group A2, 73cycles） unexplained infertility were compared. All cycles with MII oocytes were divided to IVF （groupB1, 181 cycles） and reseue-ICSI group （group B2, 26 cycles） to discuss. Results： 1.Women in group A1 were younger, but with longer history of infertility, the IVF fertilization rate of MII oocytes and 2PN fertilization rate were lower compared with group A2.The rescue-ICSI cycle rate were higher obviously in group A1 than group A2 （ 17.04% vs 4.17%, P 〈0.05） .The cancelation rate of cycles with no transferable embryos due to abnormal fertilization, failed to fertilization, and failed to cleavage or worse embryo quality in group A1 were higher than group A2 （ 11.79%vs2.74%, P〈0.05） .The implantation rate, clinical pregnancy rate and live birth rate per ET cycle had no differences in two groups.2.The fertilization rates in MII oocytes in group B1 were higher than B2 （93.82% vs 84.78%, P〈0.05） , but other indexes had no differences compared with each other. Conclusion： Couples with primary unexplained infertility had more chance with low fertilization rate or completely fertilization failure. They had the comparable IVF-ET outcomes compared with secondary unexplained infertility couples if combined short time fertilization with early rescue- ICSI.

关 键 词：不明原因不孕 IVF 短时受精 早期补救ICSI 

分 类 号：R714.8[医药卫生—妇产科学]