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目的评价卵胞浆内单精子注射(ICSI)对常规体外受精(IVF)失败病例的应用效果。方法对于常规IVF受精失败的病人在第2天进行补救ICSI(A组)21个周期,或在下一个周期直接应用ICSI技术治疗(B组)18个周期。分别与因严重少、弱精子症而行ICSI的243周期(对照组)的受精率、优质胚胎率和妊娠率等进行比较。结果A组的受精率、卵裂率、优质胚胎率分别为61.53%、81.73%、72.94%,均比B组的83.87%、97.69%、84.25%显著降低(P<0.05),而两组的多原核率差异无显著性(3.55%vs1.29%,P>0.05)。比较临床妊娠率、种植率和冷冻周期率,B组与对照组均无显著差异,而A组与对照组均有显著差异。结论常规IVF受精失败者可通过第2天补救ICSI或下一周期直接行ICSI而提高受精率和种植率,而后者比前者能获得更好的妊娠结局。
Objective To evaluate the effect of intracytoplasmic sperm injection (ICSI) on conventional in vitro fertilization (IVF) failure cases. Methods Patients with failed IVF fertilization were given ICSI (group A) 21 cycles on day 2, or 18 cycles of ICSI (group B) treatment on the next cycle. We compared fertilization rate, quality embryo rate and pregnancy rate of 243 cycles (control group) of ICSI due to severe and few asthenospermia respectively. Results The fertilization rate, cleavage rate and quality embryo rate in group A were significantly lower than those in group B (83.87%, 97.69%, 84.25%, 61.53%, 81.73%, 72.94%, respectively) There was no significant difference in multiple pronucleus rate (3.55% vs 1.29%, P> 0.05). Compared with clinical pregnancy rate, implantation rate and freezing cycle rate, there was no significant difference between group B and control group, but there was significant difference between group A and control group. CONCLUSIONS: Conventional IVF insemination improves fertility and implantation rates by either ICSI recuperation on day 2 or direct ICSI on the next cycle, while the latter achieves better pregnancy outcome than the former.