摘要
目的探讨短时受精结合早期补救卵胞浆内单精子注射(R-ICSI)的临床应用价值。方法回顾性分析2020年1月至2021年12月在广西壮族自治区生殖医院行IVF/ICSI治疗的患者临床资料。根据最终的受精方式,分为短时受精结合早期R-ICSI组(R-ICSI组,105个周期)、常规IVF组(IVF组,2058个周期)及常规ICSI组(ICSI组,486个周期),其中R-ICSI组新鲜移植周期56个,IVF组新鲜移植周期1059个,ICSI组新鲜移植周期259个。分析3组患者的基本资料、实验室指标和妊娠结局。结果基本资料比较中,3组患者的女方年龄、体质量指数(BMI)、不孕年限、促性腺激素(Gn)用量和天数、基础生殖激素水平、平均获卵数及可移植周期率均无显著差异(P>0.05);R-ICSI组和ICSI组原发不育率显著高于IVF组(P<0.05),但R-ICSI组和ICSI组之间无显著差异(P>0.05);R-ICSI组无患者使用卵泡期长方案,IVF组和ICSI组使用卵泡期长方案促排卵的周期比例无显著差异(P>0.05);R-ICSI组使用黄体期长方案促排卵的周期比例显著高于IVF组(P<0.05),但与ICSI组无显著差异(P>0.05);3组使用超长方案和拮抗剂方案促排卵的周期比例均无显著差异(P>0.05)。实验室指标比较中,R-ICSI组和ICSI组患者的总受精率和正常受精率均高于IVF组(P<0.05),但MⅡ率、多精受精率、优胚率、囊胚形成率和可用囊胚率均显著低于IVF组(P<0.05);R-ICSI组的总受精率和多精受精率显著高于ICSI组(P<0.05),而囊胚形成率显著低于ICSI组(P<0.05);ICSI组移植D3胚胎周期比例显著高于IVF组(P<0.05),但与R-ICSI组无显著差异(P>0.05);3组患者平均移植胚胎数及移植D5胚胎周期比例均无显著差异(P>0.05)。临床结局比较中,3组患者的临床妊娠率、种植率、流产率、分娩率、多胎妊娠率、异位妊娠率、活产率、出生性别比、出生体重等方面均无显著差异(P>0.05)。结论短时受精结合R-ICSI可获得较好的实验室数据和临床结局,对�
Objective:To explore the clinical application value of short-term insemination combined with early rescue intracytoplasmic sperm injection(R-ICSI).Methods:The clinical data of patients who received IVF/ICSI treatment in the Reproductive Hospital of Guangxi Zhuang Autonomous Region from January 2020 to December 2021 were retrospectively analyzed.According to the method of insemination,the patients were divided into R-ICSI group(105 cycles),conventional IVF group(2058 cycles)and conventional ICSI group(486 cycles).There were 56 fresh transplant cycles in the R-ICSI group,1059 fresh transplant cycles in the IVF group and 259 fresh transplant cycles in ICSI transplant cycles.The basic information,laboratory outcome,and pregnancy outcome were analyzed among the three groups.Results:In the comparison of basic information,there were no significant differences in female age,BMI,years of infertility,Gn dosage and days,basal sex hormone levels,average number of oocytes retrieved,and transplantable cycle rate among the three groups(P>0.05).The primary infertility rate in the R-ICSI group and ICSI group was significantly higher than that in the IVF group(P<0.05),but there was no significant difference between the R-ICSI group and ICSI group(P>0.05).No patients in the R-ICSI group used follicular phase long protocol,while there was no significant difference in the proportion of cycles used follicular phase long protocol for ovulation induction between the IVF group and the ICSI group(P>0.05).The proportion of cycles used luteal phase long protocol for ovulation induction was significantly higher than that of the IVF group(P<0.05),but there was no significant difference compared to the ICSI group(P>0.05).There was no significant difference in the proportion of cycles used super-long protocol and antagonist protocol for ovulation induction among the three groups(P>0.05).In the comparison of laboratory outcomes,the total fertilization rate and normal fertilization rate of patients in the R-ICSI group and ICSI group were higher t
作者
莫丽芬
阮秋燕
劳艳萍
王超
莫房德
钟慧芝
牛向丽
MO Li-fen;RUAN Qiu-yan;LAO Yan-ping;WANG Chao;MO Fang-de;ZHONG Hui-zhi;NIU Xiang-li(The Reproductive Hospital of Guangxi Zhuang Autonomous Region,Nanning 530029)
出处
《生殖医学杂志》
CAS
2023年第12期1813-1819,共7页
Journal of Reproductive Medicine
基金
广西卫生健康委自筹课题(Z-A20220366)。
关键词
受精失败
短时受精
早期补救ICSI
辅助生殖
Fertilization failure
Short-term fertilization
Early rescue ICSI
Assisted reproduction
