同源卵母细胞体外助孕周期中行分半IVF/ICSI的临床结局分析与探讨  

Exploration and clinical outcomes of Half-ICSI using sibling oocytes from patients in vitro reproductive technology

作　　者：于艳[1] 孙伟[1] 管群[1] 闻姬[1] 菅福琴[1] 孔风云[1] 邹智全[1] 

机构地区：[1]山东中医药大学第二附属医院生殖科,山东济南250001

出　　处：《中国现代医学杂志》2015年第1期50-53,共4页China Journal of Modern Medicine

基　　金：国家青年基金(No:81102653)

摘　　要：目的探讨可疑体外受精(IVF)受精失败的患者在体外助孕治疗周期中如何选择合理的受精方式。方法回顾性分析2009年1月-2011年12月接受体外助孕的符合指征107对夫妇,采用常规超排卵方案,每周期获得的卵子随机分半,分别进行常规IVF与ICSI(half-ICSI)治疗。结果 half-ICSI中ICSI受精率(88.3%)明显高于IVF受精率(52.1%)(P<0.01),IVF完全受精失败率(24.3%)及受精低下率(6.5%)明显高于ICSI完全受精失败率(0%)及受精低下率(0%),差异有统计学意义(P<0.05);IVF组Ⅰ级优胚率显著低于ICSI组(P<0.05);IVF和ICSI组的卵裂率、着床率及临床妊娠率比较差异无统计学意义(P>0.05)。结论对可疑IVF受精失败的患者,在患者充分知情同意下,选择half-ICSI是必要的,可提高受精率,获得足够的优质胚胎,增加妊娠机会;对常规IVF与ICSI均受精的周期,可选择移植常规IVF胚胎,减少子代遗传和先天缺陷风险。[ Objective ] To determine an optimal insemination technique for patients suspected of high risk of fer- tilization failure and undergoing assisted reproduction treatment. [Methods] One hundred and seven couples were treated by conventional in vitro fertilization （IVF） and intracytnplasmic sperm injection （ICSI） in one cycle （half-IC- SI） by dividing the sibling oocytes in halves from January 2009 to December 2011. The clinical and laboratory data were analyzed. [ Results ] In the study, the fertilization rate of ICSI （88.3%） was significantly higher than that of IVF （52.1%）（P 〈0.01）, and the rates of complete fertilization failure were （24.3%） and low fertilization（6.5%） of IVF than those of ICSI（O and 0%）, the level one of quality embryos rate of IVF was significantly lower than that of ICSI group （P 〈0.05）. No significant dift^rences were observed in the rates of eleavage, implantation and pregnancy between the two groups（P 〉0.05）. [ Conclusion ] There are indications and necessity of half-ICSI in one cycle in order to improve rate of fertilization, achieve more high quality embryos for transferring and improving the rate of pregnancy for pa- tients with high risk of fertilization failure. For the cycles with fertilization both in conventional IVF and ICSI, the option of conventional 1VF embryos transplantation may reduce the risks of genetic and congenital defect of the off-spring.

关 键 词：分半周期 同胞卵 体外受精 卵细胞胞浆内单精子注射 受精失败或低下率 

分 类 号：Q492.6[生物学—生理学]