短时受精失败后补行ICSI的临床结局.docVIP

短时受精失败后补行ICSI的临床结局 　　[摘要] 目的 评估常规体外短时受精失败后补行卵胞浆内单精子注射（ICSI）的胚胎发育情况和临床妊娠结局。 方法 回顾性分析2012年1月～2013年12月在我院行ICSI治疗的1032个新鲜移植周期，其中687个ICSI周期因单纯男性因素不育行ICSI治疗为对照组；345个ICSI周期为常规体外受精（IVF）在短时受精完全失败后行早补救性ICSI为实验组。比较两组的胚胎发育情况和临床妊娠结局。 结果 实验组正常受精率（61.4%）显著低于对照组（77.2%），优质胚胎率（58.5%）显著高于对照组（48.1%），差异有统计学意义（P0.05）。实验组分娩111例，获新生儿143名，对照组分娩231例，获新生儿295名（包括3名死产），两组新生儿早产率（13.5% vs 14.3%）、低出生体重（LBW）率（21.7% vs 20.1%）和出生缺陷率（2.1% vs 1.7%）比较，差异无统计学意义（P0.05）。 结论 常规IVF受精失败后，行早补救ICSI可明显提高受精率和优质胚胎率，并获得满意的临床妊娠结局。 　　[关键词] 体外受精；补救卵胞浆内单精子注射；胚胎发育；妊娠结局 　　[中图分类号] R713.7 [文献标识码] A [文章编号] 1674-4721（2016）04（b）-0088-04 　　[Abstract] Objective To evaluate the embryonic development situation and clinical pregnancy outcome of adding ICSI after routine short time in vitro fertilization fail. Methods 1032 fresh migration cycle，conducted ICSI from January 2012 to December 2013 of our hospital were analyzed retrospectively.687 ICSI cycle，conducted ICSI treatment resulted from pure male factor infertility，were selected as control group，and 345 ICSI cycle，adding ICSI after routine short time in vitro fertilization fail，were selected as experimental group.The embryonic development situation and clinical pregnancy outcome between two groups were compared. Results The normal fertilization rate in experimental group was 61.4%，obvious lower than that was 77.2% in control group，the good quality embryos rate was 58.5%，obvious higher than that was 48.1% in control group（P0.05）.111 were delivery in experimental group and got 143 newborns，which were respectively 231 and 295（included 3 dead-birth） in control group.The neonatal preterm birth rate，LBW rate and birth defects rate between two groups were respectively（13.5% vs 14.3%），（21.7% vs 20.1%） and （2.1% vs 1.7%），and all of the difference had no statistical significance（P0.05）. Conclusion After fail from the routine IVF，fertilization，adding early ICSI can enhance fertilization rate and good quality embryos rate obviously and can get satisfactory clinical pregnancy outco