早补救ICSI在部分受精失败患者中的临床应用  

Clinical applications of early rescue ICSI in partial fertilization failure in conventional IVF cycle

作　　者：蒋益群[1] 王珊珊[1] 徐志鹏[1] 张宁媛[1] JIANG Yi-qun;WANG Shan-shan;XU Zhi-peng;ZHANG Ning-yuan(Reproductive Medicine Center,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008)

机构地区：[1]南京大学医学院附属鼓楼医院生殖医学中心,南京210008

出　　处：《生殖医学杂志》2018年第6期525-529,共5页Journal of Reproductive Medicine

基　　金：国家自然科学基金青年基金项目(81601277)

摘　　要：目的评估早补救卵胞浆内单精子注射(R-ICSI)在常规体外受精部分受精失败周期的临床应用价值。方法回顾性分析2013~2015年在本院行部分早R-ICSI的320个周期的临床资料,根据双极体(2PB)所占比例分组:A组2PB率<25%(n=113);B组25%≤2PB率<50%(n=151);C组2PB率≥50%(n=56)。比较3组早R-ICSI来源卵母细胞的受精率、卵裂率、优质胚胎率以及临床妊娠率。结果 A、B、C 3组患者的早R-ICSI正常受精率比较无显著性差异(P>0.05);A组异常受精率(4.30%)显著低于B组(6.42%)和C组(10.38%)(P<0.05);C组2PN卵裂率(90.27%)显著低于A组(96.70%)和B组(95.44%)(P<0.05);C组优质胚胎率(46.11%)显著低于A组(62.30%)和B组(58.41%)(P<0.05)。3组中早R-ICSI来源胚胎用于移植的比例两两比较有显著性差异(P<0.05),且早R-ICSI来源胚胎中优质胚胎的比例两两比较有显著性差异(P<0.05)。3组患者移植两枚早R-ICSI来源胚胎的周期比例两两比较有显著性差异(P<0.05)。结论对于2PB率<50%的患者行早R-ICSI可以取得较理想的胚胎发育结局和妊娠结局。Objective：To evaluate the clinical outcome of early rescue intracytoplasmic sperm injection（R-ICSI）after partial fertilization failure in conventional IVF cycle.Methods： The data of 320 partial R-ICSI cycles in our hospital from 2013 to 2015 were retrospectively analyzed.According to the 2PB rate,the cycles were divided into three groups：group A：2PB rate 25%（n=113）,group B：25% ≤2PB rate 50%（n=151）,group C：2PB rate≥50%（n=56）.The rates of fertilization,the cleavage,high quality embryo formation and clinical pregnancy after treatment with R-ICSI were compared among the three groups.Results：There was no significant difference in the normal fertilization rate of early R-ICSI among the group A,B and C（P〈0.05）.The polyploid rate in group A（4.30%）was significantly lower than that in group B（6.42%）and group C（10.38%）（P〈0.05）.The 2 PN cleavage rate in group C（90.27%）was significantly lower than that both in group A（96.70%）and group B（95.44%）（P〈0.05）.The high quality embryo formation rate in group C（46.11%）was significantly lower than that in group A（62.30%）and group B（58.41%）（P〈0.05）.There were significant differences in the proportion of both transplanted embryos and high quality embryos from early R-ICSI among the three groups（P〈0.05）.There were significant differences in the proportion of the cycle with two embryos transfered from early R-ICSI among the three groups（P〈0.05）.Conclusions：The patients with less than 50% 2PB rate can obtain ideal fertilization,cleavage and high quality embryo rate after treatment with R-ICSI.

关 键 词：体外受精 补救卵胞浆内单精子注射 短时受精 部分受精失败 

分 类 号：R714.8[医药卫生—妇产科学]