摘要
【目的】分析体外受精(IVF)和卵胞浆内单精子注射(ICSI)治疗中完全受精失败(TFF)发生的临床原因。【方法】收集本中心2007年1月至2011年5月间辅助生殖治疗数据,分IVF组(5778例)、half-ICSI组(146例)、ICSI组(821例)和PESA-ICSI组(274例)进行χ2检验、t-检验和Logistic回归分析等统计分析,并对部分ICSI完全受精失败卵母细胞进行免疫荧光染色和激光共聚焦显微镜观察。【结果】IVF组和ICSI组TFF发生率分别为2.1%和2.3%(P>0.05);half-ICSI组IVF部分TFF发生率为21.9%,显著高于其他各组(P<0.01)。除half-ICSI组,其他各组中获成熟卵数≤3的患者TFF发生率高于获成熟卵数>3患者(P<0.01)。单纯畸精子症对IVF和ICSI治疗周期受精结果的影响无统计学意义(P>0.05),且前次IVF受精失败不影响再次ICSI的受精结局(P>0.05),但少精和弱精是辅助生殖治疗周期受精失败的高危影响因素(P<0.05)。【结论】低获卵数是辅助生殖治疗中完全受精失败的高危因素,获取适当数目成熟卵母细胞是治疗成功的关键;畸精子症对IVF或ICSI的受精结局无显著影响;ICSI治疗是前次IVF治疗完全受精失败患者的首选。
[Objective] To analyze the clinical factors leading to total fertilization failure （TFF） after in-vitro fertilization （IVF） or intracytoplasmic sperm injection （ICSI）. [Methods] All couples who underwent IVF （5778）, half-ICSI （146）, ICSI （821）, and PESA-ICSI （274） between January 2007 and May 2011 in our center were involved in the study. Data were analyzed by X2 test, multivariate logistic regression or student＇s t-test. Some MII oocytes of TFF in group ICSI were detected by confocal microscopy coupling with immunofluorescence. [ Results ] The TFF rates in group IVF and ICSI were 2.1% and 2.3%, respectively （P 〉 0.05）, while it was 21.9% for those undergoing IVF in group half-ICSI （P 〈 0.01 ）. The TFF rates were higher if oocyte yield was poor （~〈3） in all groups except group half-ICSI （P 〈 0.01 ）, asthenozoospermia and oligozoospermia were both high risk factors leading to TFF （P 〈 0.05）, but TFF with ICSI could not be predicted by teratozoospermia and TFF in a previous IVF cycle （P 〉 0.05 ）. [ Conclusion ] Low oocyte yield is disadvantageous for fertilization in either IVF or ICSI cycle, it is the key for success to get proper number of oocytes in an ART cycle. There is no impact for teratozoospermia on the fertilization rates in IVF or ICSI cycle. For coulpes with TFF in a previous IVF cycle, ICSI will be the first choice.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2012年第4期499-503,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省计划生育委员会科研基金(2009305)
广东省科技计划项目(2010B031600299)
广东省医学科研基金(A2012271)
关键词
体外受精
卵胞浆内单精子注射
完全受精失败
in-vitro fertilization
intracytoplasmic sperm injection
total fertilization failure
