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目的:探讨卵胞质内单精子显微注射(ICSI)后异常受精发生的影响因素。方法:回顾性分析299个ICSI周期,按照是否有异常受精分为异常受精组(n=118)和正常对照组(n=181),异常受精组至少发生1个非2原核(2PN)的受精卵。比较分析异常受精组和对照组临床和实验室资料。结果:异常受精组hCG注射日E2水平(14 097±3 066 pmol/L)高于对照组(1 2461±6 836 pmol/L),差异有统计学意义(P<0.05);异常受精组获卵数及成熟卵数分别为17.8±7.2个、15.3±6.1个,多于对照组的13.6±7.0个、10.2±5.3个,差异均有统计学意义(P<0.01);卵子成熟率(81.7%vs76.4%)、2PN受精率(78.4%vs 86.9%),组间比较差异均有统计学意义(P<0.01);而患者年龄、基础激素水平、促性腺激素(Gn)使用总量、精子来源及质量、着床率、临床妊娠率组间比较,差异均无统计学意义(P>0.05)。结论:卵巢对Gn刺激的高反应性可能与ICSI后异常受精的发生有关。异常受精卵的发生虽对临床结局无明显影响,但减少异常受精发生率,增加卵子利用率,可能会提高累积妊娠率。
Objective: To investigate the influencing factors of abnormal fertilization after intracytoplasmic sperm injection (ICSI). Methods: A total of 299 cycles of ICSI were retrospectively analyzed. At least one non-2 prokaryotic (2PN) fertilization group was established in the abnormal fertilization group according to whether abnormal fertilization was divided into abnormal fertilization group (n = 118) and normal control group (n = 181) egg. Comparative analysis of abnormal fertilization group and control group clinical and laboratory data. Results: The level of E2 at the day of hCG injection in the group of abnormal fertilization (14 097 ± 3 066 pmol / L) was significantly higher than that of the control group (2461 ± 6 836 pmol / L), the difference was statistically significant (P <0.05) The number of eggs and the number of mature eggs were 17.8 ± 7.2 and 15.3 ± 6.1, respectively, which were more than those in the control group (13.6 ± 7.0 and 10.2 ± 5.3, respectively) (P <0.01) % vs76.4%), 2PN fertilization rate (78.4% vs 86.9%), there were significant differences between the two groups (P <0.01); while the age, basal hormone level, total amount of gonadotropin , Sperm source and quality, implantation rate, clinical pregnancy rate between the two groups, the difference was not statistically significant (P> 0.05). Conclusion: The high reactivity of ovary to Gn stimulation may be related to the abnormal fertilization after ICSI. Although the incidence of abnormal fertilized eggs has no significant effect on the clinical outcome, reducing the incidence of abnormal fertilization and increasing the utilization of eggs may increase the cumulative pregnancy rate.