非男性因素不孕高龄患者IVF和ICSI治疗的临床结局比较  

Comparing clinical outcomes between IVF and ICSI in older women with non-male factor infertility

作　　者：马龙[1] 董娟[1] 夏梦[1] 孟慧 蔡令波[1] 刘嘉茵[1] MA Long;DONG Juan;XIA Meng;MENG Hui;CAI Ling-bo;LIU Jia-yin(Center of Clinical Reproductive Medicine,First Affiliated Hospital of Nanjing Medical University,Nanjing 210029)

机构地区：[1]南京医科大学第一附属医院临床生殖医学中心,南京210029

出　　处：《生殖医学杂志》2022年第9期1193-1197,共5页Journal of Reproductive Medicine

基　　金：国家重点研发计划(2021YFC2700404);国家自然科学基金(81730041);江苏省卫生厅项目(JX10231802)。

摘　　要：目的分析非男性因素不孕的高龄患者常规体外受精(IVF)和卵胞浆内单精子注射(ICSI)周期临床结局的差异。方法回顾性分析2018年1月至2020年12月在本中心行IVF/ICSI治疗的非男性因素不孕高龄患者的临床资料,共纳入3107个周期,包括2876个IVF周期和231个ICSI周期。根据受精方式不同分为IVF组和ICSI组,比较两组患者的一般资料、受精和胚胎发育情况及临床妊娠结局。结果一般情况比较:两组患者的平均年龄、不孕年限、体质量指数(BMI)、子宫内膜厚度均无显著性差异(P>0.05);IVF组基础促卵泡生成素(FSH)水平显著高于ICSI组(P<0.05),IVF组抗苗勒管激素(AMH)水平、窦卵泡数(AFC)、获卵数均显著低于ICSI组(P<0.05)。受精和胚胎发育情况:IVF组正常受精率显著低于ICSI组(P<0.05),异常受精率显著高于ICSI组(P<0.05),两组患者的完全受精失败率、卵裂率、可移植胚胎率、优质胚胎率均无显著差异(P>0.05)。临床妊娠结局情况:两组患者的临床妊娠率、流产率和活产率差异均无统计学意义(P>0.05)。结论对于非男性因素不孕高龄患者,ICSI并不能改善辅助生殖技术的助孕结局。Objective:To compare clinical outcomes between conventional IVF and ICSI in the elder patients with non-male factor infertility.Methods:The clinical data of elder patients with non-male factor infertility who underwent IVF or ICSI treatment in our center from January 2018 to December 2020 were retrospectively analyzed.A total of 3107 cycles were included,including 2876 IVF cycles and 231 ICSI cycles.The general information,fertilization and embryo development and clinical pregnancy outcome were compared between the two groups.Results:There were no significant differences in average age,infertility years,body mass index(BMI)and endometrial thickness between the two groups(P>0.05).The baseline FSH was significantly higher(P<0.05),while the AMH value,the antral follicles count(AFC),and the number of oocytes retrieved in the IVF group were significantly lower compared with the ICSI group(P<0.05).The fertilization rate in the IVF group was significantly lower(P<0.05),and the abnormal fertilization rate was significantly higher than that in the ICSI group(P<0.05).The total fertilization failure rate,cleavage rate,transferable embryo rate and high-quality embryo rate were comparable between IVF and ICSI groups(P>0.05).There were no differences in clinical pregnancy,miscarriage and live birth rates between the two groups(P>0.05).Conclusions:ICSI does not improve pregnancy outcomes of assisted reproductive technology in older women with non-male factor infertility.

关 键 词：体外受精 卵胞浆内单精子注射 受精率 妊娠率 活产率 

分 类 号：R711.6[医药卫生—妇产科学]