两种补救性ICSI在常规体外受精中的应用

目的探讨在常规体外受精-胚胎移植(IVF-ET)周期中不受精及受精率低的情况下,应用卵胞浆内单精子显微注射(ICSI)进行补救后获得胚胎移植的临床应用价值。方法选择IVF周期中发生完全不受精及受精率<30%的病例97个周期,其中57个周期行晚期补救ICSI,40个周期行早期补救ICSI,两种补救ICSI在完全不受精组和受精率低组中分别进行比较。结果在不受精组中,早期补救的2PN受精率、种植率和妊娠率分别为69.44%、28.00%、30.77%,明显高于晚期补救ICSI的56.23%、1.00%、2.50%(P<0.05或P<0.01),在低受精率组中两者的累计妊娠率、种植率差异无显著性(P>0.05),但受精率、优质胚胎率、胚胎冷冻率差异有高度显著性(P均<0.01)。结论早期补救ICSI较晚期ICSI的2PN受精率、胚胎种植率高,能更好地改善补救ICSI的妊娠结局。

The efficacy of two methods of intracytoplasmic sperm injection compensate for conventional in vitro fertilization program

Objective To investigate the effectiveness of delayed oocyte reinsemination by intracytoplasmic sperm injection(ICSI) as compensation for total fertilization failure and low fertilization in cycles of conventional in vitro fertilization and embryo transfer(IVF-ET). Methods 97 cycles of total fertilization failure and low fertilization(<30%) in IVF were analyzed in our centre.57 cycles received later compensatory ICSI and 40 cycles received early compensatory ICSI,the two methods of compensatory ICSI were used in the total fertilization failure group and low fertilization group,respectively. Results There were significant differences in comparison of the 2PN fertilization rate,the implantation rate and the pregnancy rate between the early compensatory ICSI and the later compensatory ICSI in the total fertilization failure group(P<0.05 or P<0.01),which were 69.44%,28.00%,30.77% and 56.23%,1.00%,2.50%,respectively.There were no significant differences in comparison of the accumulative total pregnancy rate and the implantation rate between the early compensatory ICSI and the later compensatory ICSI in the low fertilization group(P>0.05),but there were significant differences in comparison of the 2PN fertilization rate,the good embryos rate and the freezing embryos rate(all P<0.01).Conclusion The unfertilization oocytes after IVF can be fertilized by compensatory ICSI.The developmental potential of the ensuing embryos in early compensatory ICSI is better(with higher 2PN fertilization rate and implantation rate) than later compensatory ICSI.