摘要
目的:探讨IVF-ET完全体外受精失败发生的相关危险因素。方法:回顾性分析行常规体外受精-胚胎移植(IVF-ET)的2 429个周期。应用单因素及多因素Logistic回归分析夫妇之间受孕史、精子正常形态率、精液量、精液浓度、精液活力、男方生育史、女方年龄、女方原发/继发不孕、是否有输卵管性因素、不孕年限、获卵数、月经第3日的FSH、T、PRL、LH、E2、hCG注射前LH、E2、P对完全受精失败发生的影响。结果:IVF完全不受精发生率为5.7%。完全受精失败组的精子正常形态率(11.1±5.8%)、a+b级百分比(47.4±10.5%)显著低于受精组(13.4±5.3%、50.1±8.6%)(P<0.05);完全受精失败组的女方原发不孕构成比(69.1%)、男方原发不孕构成比(74.8%)、无管性因素构成比(30.2%)、夫妇间无受孕史构成比(79.1%)显著高于受精组(36.3%、41.7%、13.6%、44.3%)(P<0.05)。此外,畸精组的完全不受精发生率(15.0%)显著高于精子形态正常组(5.2%)。Logistic回归分析亦显示精子正常形态率、精液浓度、夫妇间受孕史、不孕年限与完全受精失败有显著相关性(P<0.05)。结论:对治疗周期中畸形精子症患者、精液浓度、活力偏低、男方原发不育、女方原发不孕、无输卵管性因素、不孕年限长、夫妇之间无孕史的患者应纳入受精失败的高危人群,考虑行部分ICSI,以保障受精,对防止完全不受精的发生具有积极意义。
Objective： To analyze the factors relating with fertilization failure in conventional IVF cycles. Methods： The total fertilization failure rate of 2 429 IVF cycles were retrospectively analyzed. Risk factors were identified by univariate and multivariate logistic regression analyses. Results： The total fertilization failure rate of conventional IVF-ET rate was 5.7% （139/2 429）. The percentage of morphologically normal sperm （11.1 ± 5.8% vs 13.4 ± 5.3%）, progressive motility （47.4 ± 10.5% vs 50.1 ± 8.6%）, percentage of couple primary infertility （79.1% vs 44.3%）, percentage of female primary infertility （69.1% vx 36.3%）, percentage of male primary infertility （74.8% vs 41.7%）, percentage of without oviduct obstruction patients （30.2% vs 13.6%） and percentage of couples primary infertility （79.1% vs 44.3%） of the fertilization failure patients were significantly different from those oft he fertilized patients （P〈0.05）. Besides, higher total fertilization failure rate was found in couples with isolated teratozoospermia than in couples with normal percentage of morphologically normal sperm （15.0% vs 5.2%）. Aider that, it was found by multivariate logistic regression analyses that many factors including percentage of morphologically normal sperm, sperm concena＇ation, couples primary infertility and female infertility years were related with fertilization . Conclusion： Patients with low percentage of morphologically normal sperm （〈4%）, tow sperm concentration and motility, male primary infertility, female primary infertility, without oviduct obstruction, long female infertility years or/and couples primary infertility are at high risk of fertilization failure. More attention should be paid to these patients for avoiding the fertilization failure.
出处
《生殖与避孕》
CAS
CSCD
2013年第1期21-25,共5页
Reproduction and Contraception
关键词
正常形态精子下限值
体外受精
完全失败
low limit of sperm with normal morphology
IVF-ET
total fertilization failure
