不明原因不孕妇女卵子受精方式的选择及结局分析

发布时间：2018-03-09 15:53

本文选题：不明原因不孕　切入点：短时受精　出处：《南京医科大学学报(自然科学版)》2015年05期 　论文类型：期刊论文

【摘要】：目的 :了解3周期以上宫腔内人工控授精(IUI)失败的不明原因,探讨不孕夫妇采取何种卵子受精方式更为安全有效。方法:回顾性分析本中心5年间3周期以上IUI失败的不明原因不孕共321例。根据不孕夫妇对于卵子受精方式的选择,将其分为3组:体外受精(IVF)(备Rescue-ICSI)组(213例)、一半行卵细胞胞浆内单精子注射(Half-ICSI)组(69例)、卵细胞胞浆内单精子注射(ICSI)组(39例)。结果:3组中年龄、基础促卵泡激素(FSH)、促性腺激素(Gn)天数、Gn用量无统计学差异。IVF组妇女不孕年限与其他两组相比有差异,Half-ICSI组妇女窦卵泡计数和获卵数较其他两组多,ICSI组最少。IVF完全不受精发生率为18.8%(53/282)。3组总受精率、卵裂率无统计学差异,3组临床妊娠率、种植率和活产率相似,但3组的优质胚胎率、流产率有统计学差异。其中IVF(备Rescue-ICSI)组优质胚胎率高于ICSI组,而流产率较Half-ICSI组低(P0.05)。结论:对于不明原因不孕妇女卵子受精方式的选择,与Half-ICSI和ICSI相比,IVF后短时受精联合补救ICSI是一个相对更安全、经济、有效的受精方式。
[Abstract]:Objective: to understand the unknown causes of the failure of IUI in human labor control insemination for more than 3 cycles. Methods: a total of 321 infertile couples who had failed IUI for more than 3 cycles in 5 years were analyzed retrospectively. They were divided into three groups: in vitro fertilization (IVF) group (n = 213), half of them were treated with Half-ICSI (n = 69) and 39 with ICSI (intracytoplasmic sperm injection) group (n = 39). There was no significant difference in the dosage of Gn between the basic follicle stimulating hormone (FSH) and gonadotropin (Gn). There was no significant difference in the number of infertile women in the IVF group compared with the other two groups. The number of antral follicles and the number of eggs obtained in the Half-ICSI group were less than those in the other two groups. The rate of fertilization was 18. 8% in 53 / 282. 3 group, and the fertilization rate was 18. 8% in 53 / 282. 3 group. There was no statistical difference in cleavage rate. The clinical pregnancy rate, implantation rate and live birth rate were similar among the three groups, but there were significant differences in the rate of high quality embryo and abortion in the three groups, in which the rate of high quality embryo in IVF (Rescue-ICSI) group was higher than that in ICSI group. The abortion rate was lower than that in Half-ICSI group (P 0.05). Conclusion: compared with Half-ICSI and ICSI, short term fertilization combined with ICSI is a more safe, economical and effective fertilization method for unexplained infertile women.
【作者单位】：南京医科大学第一附属医院生殖医学中心;
【基金】：江苏省卫生厅科教兴卫工程项目(ZX201110) 江苏省高校优势学科(PAPD)
【分类号】：R711.6

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