论文部分内容阅读
目的对比分析短时体外受精(IVF)或短时IVF联合早期补救卵胞浆内单精子显微注射(ICSI)与部分卵胞浆内单精子显微注射(half-ICSI)两种授精方式在首次助孕周期对预防IVF受精率低下的疗效。方法回顾性分析2015年5月1日—2016年12月31日初次助孕周期中因存在精卵结合障碍高危因素而接受短时IVF(或短时IVF联合联合早期补救ICSI)或half-ICSI预防IVF受精率低下患者的病例资料。根据授精方式分为短时IVF助孕组(A组,n=192)和half-ICSI助孕组(B组,n=85),比较两组患者的一般情况、受精情况、胚胎发育以及接受新鲜胚胎移植后的妊娠结局。为进一步分析受精情况,筛选A、B两组中IVF受精率低下周期(受精率≤30%)的患者,分别设为A1组(n=20)和B1组(n=9),比较A1、B1两组的卵子受精情况。结果与B组相比,A组不存在过度ICSI(0.0%vs89.8%,χ~2=479.888,P<0.01)。A组正常受精率低于B组(73.3%vs 79.6%,χ~2=14.780,P<0.01),但两组可用胚胎率、优质胚胎率、囊胚形成率以及接受新鲜胚胎移植后临床妊娠率、胚胎着床率、流产率差异均无统计学意义(P均>0.05)。IVF受精率低下周期中,短时IVF联合早期补救ICSI可提高正常受精率(A1组77.9%,B1组49.4%,χ~2=28.833,P<0.01)。结论相比half-ICSI,短时IVF联合早期补救ICSI可避免过度ICSI、提高IVF受精率低下周期的正常受精率,预防IVF受精率低下更加精确、有效。
Objective To compare the effects of single insemination (IVF) or short-term IVF combined with intracytoplasmic sperm injection (ICSI) and partial intracytoplasmic sperm injection (half-ICSI) The efficacy of the first pregnancy-assisted cycle in preventing IVF fertilization is low. Methods A retrospective analysis of short-term IVF (or short-term IVF combined with early rescue ICSI) or half-ICSI in the first trimester of pregnancy during the first trimester of pregnancy from May 1, 2015 to December 31, 2016 was retrospectively analyzed. Prevention of IVF cases in patients with low fertility. According to the mode of insemination, the short-term IVF pregnancy group (group A, n = 192) and the half-ICSI pregnancy group (group B, n = 85) were divided into two groups according to their fertilization conditions, fertilization status, embryo development, Pregnancy outcome after fresh embryo transfer. For further analysis of fertilization, patients in groups A and B who had a low IVF fertilization rate (fertilization rate ≤30%) were selected as group A1 (n = 20) and group B1 (n = 9) B1 two groups of eggs fertilization situation. Results Compared with group B, there was no over ICSI in group A (0.0% vs 89.8%, χ ~ 2 = 479.888, P <0.01). The normal fertilization rate in group A was lower than that in group B (73.3% vs 79.6%, χ ~ 2 = 14.780, P <0.01). However, the available embryo rate, high quality embryo rate, blastocyst formation rate and clinical pregnancy after fresh embryo transfer Rate, embryo implantation rate, abortion rate differences were not statistically significant (P all> 0.05). Short-term IVF combined with early rescue ICSI increased normal fertilization rate in IVF fertilization cycles (77.9% in A1 group, 49.4% in B1 group, χ ~ 2 = 28.833, P <0.01). Conclusions Compared with half-ICSI, short-term IVF combined with early rescue ICSI can avoid excessive ICSI, improve normal fertilization rate in IVF low fertilization cycles and prevent IVF fertilization rate from being more accurate and effective.