162个显微受精完全失败周期原因分析.docVIP

162个显微受精完全失败周期的原因分析 　　[摘要] 目的 探讨显微受精完全失败的原因和应对策略。 方法 选取本院生殖内分泌科2005年1月～2014年1月收治的经历显微受精完全失败的138位患者的162个周期为A组，曾经发生过完全受精失败但再次助孕有胚胎移植的72位患者的96个周期为B组，两次以上反复完全受精失败的27位患者的33个周期为C组，分析3组患者的年龄、基础内分泌情况、不孕原因、窦卵泡数、用药方案、获卵数、MⅡ卵数等。 结果 B组采卵日E2水平[（1802.8±88.1）pg/ml]显著高于A、C组[（1624.2±195.3）、（1739.4±277.3）pg/ml]（P=0.02）；B组的获卵数[（3.5±0.6）个]显著多于A、C组[（1.7±0.1）、（2.4±0.3）个]（P=0.01）；B组MⅡ卵数[（2.9±0.4）个]显著多于A、C组[（1.3±0.1）、（2.1±0.2）个]（P=0.01）。B组同一患者在发生完全受精失败周期的获卵数、MⅡ卵数显著少于有胚胎移植周期（P0.05）。B组的妊娠结局：HCG阳性率为50%，生化妊娠率为16%，临床妊娠率为34%，仅2人成功分娩，活产率为2%。 结论 获卵数和成熟卵数过少可能是显微受精完全失败的最主要原因，提高其获卵数和成熟卵数或许可以增加成功妊娠的机会，但是，有胚胎移植患者的活产率仍很低。 　　[关键词] 受精失败；卵胞浆内单精子注射；成熟卵母细胞 　　[中图分类号] R271.14 [文献标识码] A [文章编号] 1674-4721（2016）03（a）-0107-04 　　[Abstract] Objective To discuss the reason and coping strategy for complete failure of micro fertilization. Methods 162 periods of 138 patients having complete failure of micro fertilization were selected as group A，96 periods of 72 patients having embryo transplantation by assisted reproduction after having previous complete fertilization failure were selected as group B，while 33 periods of 27 patients with more than twice complete failure of fertilization were selected as group C，and patients were treated by department of reproductive endocrinology of our hospital from January 2005 to January 2014.The age，baseline endocrine，reasons of infertility，antral follicle count，therapeutic regimen，retrieved oocyte number，and oocyte number of MⅡ and so on in three groups was analyzed respectively. Results E2 level was significantly higher on OR in group B [（1802.8±88.1） pg/ml] than that in group A and group C [（1624.2±195.3） pg/ml，（1739.4±277.3） pg/ml] （P=0.02）.The retrieved oocyte number [（3.5±0.6） oocytes] in group B was significantly higher than that in group A and group C [（1.7±0.1） oocytes，（2.4±0.3） oocytes] （P=0.01）.MⅡoocyte number in group B [（2.9±0.4） oocytes] was significantly higher than that in group A and group C [（1.3±0.1） oocytes，（2.1±0.2） oocytes] （P=0.01）.Retrieved oocyte number