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目的:借助于辅助生殖技术,进一步明确“原因不明性不孕”患者的病因。方法:回顾性分析2011年1~12月在华中科技大学附属同济医院生殖中心行体外受精胚胎移植(IVF-ET)和卵母细胞胞浆内单精子注射术(ICSI)的原因不明性不孕患者54例和单纯输卵管梗阻患者244例,比较两组受精情况、胚胎发育潜能、临床结局及卵母细胞异常形态比例之间有无差异。结果:两组在年龄、不孕年限、基础窦卵泡数和平均获卵数上均有统计学差异(P=0.000)。不明原因患者受精率较输卵管患者低,差异有统计学意义(57.93%vs62.72%,P<0.05)。不明原因组补救ICSI率明显高于输卵管梗阻组(25.00%vs6.07%,P=0.000)。不明原因患者的卵母细胞异常形态率显著高于输卵管梗阻组(18.15%vs8.68%,P=0.000)。两组优胚率、可利用囊胚率、种植率和临床妊娠率均无统计学差异(P>0.05)。结论:精卵结合障碍和卵母细胞形态异常可能是不明原因性不孕患者潜在的不孕因素。
Objective: With the aid of assisted reproductive technology, to further clarify the “unexplained infertility,” the cause of the patient. Methods: The retrospective analysis of the causes of unidentified infertility in IVF-ET and ICSI in Tongji Hospital Affiliated to Huazhong University of Science and Technology from January to December 2011 was retrospectively analyzed. 54 patients and simple tubal obstruction in 244 patients, fertilization, embryo development potential, clinical outcome and the difference between the oocyte morphological differences were compared. Results: There were significant differences in age, duration of infertility, basal antral follicles and average number of oocytes retrieved (P = 0.000). Unconscious patients with lower tubal fertilization rate, the difference was statistically significant (57.93% vs62.72%, P <0.05). The ICSI rate of unreasonable group was significantly higher than that of tubal obstruction group (25.00% vs 6.07%, P = 0.000). The abnormal morphological rate of oocytes in patients with unknown causes was significantly higher than that in tubal obstruction patients (18.15% vs 8.68%, P = 0.000). The two groups of excellent embryo rate, available blastocyst rate, implantation rate and clinical pregnancy rate were no significant difference (P> 0.05). CONCLUSIONS: Sperm-egg disability and oocyte morphologic abnormalities may be potential causes of infertility in patients with unexplained infertility.