摘要
目的探讨40岁及以上高龄女性患者行试管助孕时,ICSI相较IVF能否改善胚胎及临床结局。方法回顾性分析2018年1月至2019年6月在同济大学附属第一妇婴保健院生殖中心行IVF或ICSI治疗的高龄非男性因素不孕患者的临床资料(女方年龄≥40岁,男方精液正常),比较受精率、可用胚胎数、优胚数、妊娠结局及母儿并发症等的发生情况。结果共纳入358个取卵周期,根据受精方式分IVF组(222个周期)和ICSI组(136个周期)。两组一般基线资料无显著差异。IVF组每取卵受精率显著高于ICSI组(IVF组80.6%,ICSI组63.2%,P<0.001)。IVF组受精数、卵裂数、优质胚胎数、可用胚胎数、冷冻胚胎数明显多于ICSI组(P<0.05)。在首次试管失败,行再次取卵的周期中,IVF组每取卵周期受精率仍显著高于ICSI组(IVF组86.4%,ICSI组62.2%,P<0.05),优质胚胎率、可用胚胎率IVF组略低于ICSI组(P<0.05),但移植后临床妊娠率、持续妊娠率、活产率、流产率、胚胎种植率、累计活产率两组间无显著差异(P>0.05)。结论对高龄非男性因素不孕患者选择ICSI对改善胚胎及临床结局无益处。
Objective To explore whether the use of ICSI can improve reproductive outcomes compared to conventional IVF in women with advanced maternal age with non-male factor infertility.Methods A retrospective,single center study included women,aged≥40,who underwent IVF treatments for non-male factor infertility between January 2018 to Jun 2019in the First Maternity and Infant Health Hospital Affiliated to Tongji University.Women had to be at least 40 years and their male partner had to have normal sperm parameters.The primary outcome was the fertilization rate per oocytes retrieval and per oocytes inseminated/injected.Results A total of 358 women were included in the study.Of these,222 women underwent conventional IVF and 136 women underwent ICSI.Baseline characteristics were similar between the two groups.The fertilization rates per oocytes retrieval were higher in IVF group(80.6%)compared to ICSI group(63.2%,P<0.001).In the repeated cycles,the fertilization rate in IVF group was still significantly higher than that in ICSI group(86.4% in IVF group and 62.2%in ICSI group,P<0.05),the rate of high-quality embryos and available embryos in IVF group were lower than that in ICSI group(P<0.05).However,there was no significant difference between the two groups in clinical pregnancy rate,continuous pregnancy rate,live birth rate,abortion rate,embryo implantation rate and cumulative live birth rate after transplantation(P>0.05).Conclusion The use of ICSI for the indication of advanced maternal age shows no benefit over conventional IVF when applied for non-male factor infertility.
作者
瞿俊杰
陈智勤
陈淼鑫
李昆明
滕晓明
QU Junjie;CHEN Zhiqin;CHEN Miaoxin;LI Kunming;TENG Xiaoming(Department of Reproductive Medicine,First Maternity and Infant Hospital Affiliated to Tongji University,Shanghai 200040,China)
出处
《中国优生与遗传杂志》
2023年第3期447-452,共6页
Chinese Journal of Birth Health & Heredity
