女方卵巢低反应-男方精液正常人群行ICSI改善临床结局分析  

The clinical outcomes of ICSI in women with low ovarian response and men with normal semen

作　　者：许雯[1] 竺海燕[1] 韦群[1] 王紫莲[1] 童晓嵋[1] 张松英[1] Xu Wen

机构地区：[1]浙江大学医学院附属邵逸夫医院妇产科,浙江省生殖障碍诊治研究重点实验室,310016

出　　处：《浙江临床医学》2020年第12期1700-1703,共4页Zhejiang Clinical Medical Journal

基　　金：国家重点研发项目(2018YFC1004800);国家自然科学基金(81601236);浙江省自然科学基金(LY19H040009);浙江省医药卫生科技计划项目(2019RC195)。

摘　　要：目的评价女性卵巢低反应患者是否可通过卵泡浆内单精子注射技术(ICSI)来改善临床结局。方法收集2015年1月至2017年12月因女方卵巢低反应而男方精液正常行ICSI的1672个周期作为ICSI组。选取同期的卵巢低反应而男方精液正常行体外受精(IVF)的3117个周期作为IVF组。回顾性比较两组的受精率、优胚率、妊娠率、着床率及活产率。结果ICSI组女方取卵年龄比IVF组高(P<0.05)。两组的穿刺卵泡数、获卵数差异无统计学意义(P>0.05)。ICSI组两原核(2PN)受精率75.4%(2141/2841)及2PN胚胎数(1.5±0.7)明显高于IVF组69.4%(3941/5676)、(1.4±0.7)(P<0.05)。ICSI组2PN优质胚胎数(1.2±0.5)、2PN优质胚胎率43.4%(946/2181)以及每获卵2PN优质胚胎率33.3%(946/2841)略低于IVF组(1.2±0.5)、45.3%(1987/4389)、35%(1987/5676),差异均无统计学意义(P>0.05)。ICSI组移植胚胎数、移植优胚数、移植优胚率均略高于IVF组,差异均无统计学意义(P>0.05)。ICSI组妊娠率、着床率、活产率略低于IVF组,差异均无统计学意义(均P>0.05)。结论ICSI受精能够一定程度提高胚胎受精率,但是无法改善妊娠结局。Objective To evaluate whether ICSI can improve clinical outcomes in women with poor ovarian response and non-male factor subfertility.Methods A total of 1,672 cycles of ICSI fertilization with poor ovarian response and non-male factor subfertility in the reproductive Center of Sir Run Run Shaw Hospital from January 2015 to December 2017 were collected as the ICSI group.During the same period,3,117 cycles of IVF fertilization were selected as the IVF group.The fertilization rate,high quality embryo rate,pregnancy rate,implantation rate and live birth rate of the two groups were compared retrospectively.Results The age of female in ICSI group was higher than that in IVF group(P<0.05).There was no significant statistically difference in the number of punctured follicles and oocytes between the two groups(P>0.05).The 2PN fertilization rate in ICSI group 75.4%(2141/2841)was higher than that in IVF group 69.4%(3941/5676)(P<0.05).The number of 2PN embryos in ICSI group was higher than that in IVF group(1.5±0.7 vs 1.4±0.7,P<0.05).There were no significant stitically differences between ICSI and IVF group in the number of 2PN high-quality embryos(1.2±0.5 vs 1.2±0.5),the rate of 2PN high-quality embryos(43.4%vs 45.3%),and the rate of 2PN high-quality embryos per every oocytes(33.3%vs 35.0%)(P>0.05).The number of transplanted embryos,the number of transplanted high-quality embryos and the rate of transplanted high-quality embryos were higher in the ICSI group,the differences were not stistically significant(P>0.05).The pregnancy rate in ICSI group,the implantation rate and the live birth rate slightly lower than that in IVF group,there were no significant differences(P>0.05).Conclusion ICSI can improve the embryofertilization rate,but it cannot improve the clinical outcomes.

关 键 词：卵巢低反应 受精率 临床妊娠率 活产率 

分 类 号：R71[医药卫生—妇产科学]