既往不孕类型及早期补救ICSI对IVF临床结局的影响

发布时间：2018-03-25 13:21

本文选题：原发不孕　切入点：继发不孕　出处：《中国妇产科临床杂志》2017年01期

【摘要】：目的探讨常规IVF中原发、继发不孕患者及早期补救ICSI对临床结局的影响。方法回顾性分析2012年1月至2014年12月行常规IVF及ICSI助孕治疗患者资料1 733个周期,将1 097个IVF周期分为原发不孕组(571例)与继发不孕组(526例),比较两组患者不孕年限、年龄、基础内分泌、Gn总量、Gn天数、卵子受精率、胚胎种植率、补救率和妊娠率;针对不同的受精方式,还比较了IVF组、ICSI组、R-ICSI组的受精率、卵裂率、种植率、妊娠率及流产率。结果原发不孕组与继发不孕组比较,经独立样本t检验,不孕年限差异有统计学意义(P0.05),原发不孕组妊娠率、胚胎种植率与继发不孕组比较,经卡方检验,差异无统计学意义(P0.05);原发不孕组卵子受精率(χ~2=23.641,P=0.000)、正常受精率(χ~2=4.042,P=0.045)、卵裂率(χ~2=4.015,P=0.045)、补救ICSI率(χ~2=5.044,P=0.025)与继发不孕组比较,经卡方检验,差异有统计学意义(P0.05);IVF组、ICSI组及R-ICSI组临床结局差异无统计学意义(P0.05)。结论常规IVF受精中,原发不孕患者卵子受精率及正常受精率低,短时受精联合R-ICSI可以有效地挽救IVF受精失败的患者,能够获得较好的妊娠结局。
[Abstract]:Objective to investigate the effect of primary, secondary infertility and early rescue ICSI on clinical outcome in routine IVF. Methods from January 2012 to December 2014, 1 733 cycles of routine IVF and ICSI assisted pregnancy therapy were retrospectively analyzed. 1 097 IVF cycles were divided into primary infertility group (n = 571) and secondary infertility group (n = 526). The fertilization rate, cleavage rate, implantation rate, pregnancy rate and abortion rate in IVF group were compared with those in secondary infertility group. The pregnancy rate and embryo implantation rate in primary infertility group were compared with those in secondary infertility group, and were compared with those in secondary infertility group by chi-square test. There was no significant difference between primary infertility group and secondary infertility group (P 0.05). The fertilization rate of primary infertility group was 23.641%, the normal fertilization rate was 0.045%, the cleavage rate was 0.045% (蠂 ~ 24.015), and the recovery ICSI rate (蠂 ~ (25.044) P ~ (0.025)) was higher than that in secondary infertility group. There was no significant difference in clinical outcome between ICSI group and R-ICSI group. Conclusion in conventional IVF fertilization, egg fertilization rate and normal fertilization rate in primary infertile patients are low. Short-term fertilization combined with R-ICSI can effectively save patients with failed IVF fertilization and obtain better pregnancy outcomes.
【作者单位】：内蒙古医科大学附属医院生殖医学中心;

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