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目的:探讨早期补救ICSI的应用价值。方法:回顾性分析IVF受精失败、取卵后20h行补救ICSI者19例(晚补救ICSI,A组)及加精子(IVF)4~6h后未见第二极体(Pb2)的成熟卵行补救ICSI者31例(早补救ICSI,B组),并与544例同期常规ICSI(C组)进行比较,观察受精率、卵裂率、有效胚胎率、优质胚胎率、胚胎种植率、临床妊娠率,评价早补救ICSI有效性。结果:3组年龄及基础FSH均无统计学差异,B组正常受精率显著高于A组,但显著低于C组(71.27%vs55.69%vs81.08%,P<0.05),>2原核(PN)率A、B组间无统计学差异,但显著高于C组(7.73%vs7.78%vs2.73%,P<0.01),卵裂率B组显著高于A组(100%vs94.62%,P<0.05),有效胚胎率3组间无统计学差异,优质胚胎率B组显著高于A组,但低于C组(51.16%vs22.73%vs60.19%,P<0.01),胚胎种植率B组显著高于A组(1.75%vs17.54,P<0.05),与C组比较无统计学差异(17.54%vs18.90%,P>0.05),3组临床妊娠率分别为5.26%,26.67%和34.57%,与C组比,A组临床妊娠率显著下降(P<0.01)。结论:与晚补救ICSI相比,早补救ICSI获得了更高的受精率、卵裂率、优质胚胎率及种植率,但多PN率高于常规ICSI,优质胚胎率仍低于常规ICSI。
Objective: To explore the value of early recovery ICSI. Methods: The IVF fertilization failure was retrospectively analyzed. Twenty-nine hours after oocyte retrieval, there were no mature second egg body (Pb2) mature egg lines in 19 ICSI patients (late ICSI group A) and 4 ~ 6 h after sperm injection (IVF) The ICSI was recovered in 31 cases (early recovery ICSI, group B) and compared with 544 cases of routine ICSI (group C). The effects of fertilization rate, cleavage rate, effective embryo rate, good embryo rate, embryo implantation rate, clinical pregnancy Rate, evaluate early recovery ICSI effectiveness. Results: There was no significant difference in age and basic FSH between the three groups. The normal fertilization rate in group B was significantly higher than that in group A, but significantly lower than that in group C (71.27% vs55.69% vs81.08%, P <0.05) The prokaryotic (PN) rate was not significantly different between group A and group B, but significantly higher than group C (7.73% vs 7.78% vs 2.73%, P <0.01). The cleavage rate in group B was significantly higher than that in group A % vs94.62%, P <0.05). There was no significant difference in the effective embryo rate among the three groups. The rate of high quality embryo in group B was significantly higher than that in group A, but lower than that in group C (51.16% vs22.73% vs60.19% P <0.01). The rate of embryo implantation in group B was significantly higher than that in group A (1.75% vs 17.54, P <0.05), but there was no significant difference between group B and C (17.54% vs 18.90%, P> 0.05) The clinical pregnancy rates were 5.26%, 26.67% and 34.57% respectively. Compared with group C, the clinical pregnancy rate in group A was significantly decreased (P <0.01). CONCLUSIONS: Early recovery of ICSI achieved higher rates of fertilization, cleavage, high quality embryo and implantation compared with late recovery ICSI, but the multiple PN was higher than that of conventional ICSI and the rate of high quality embryos was still lower than that of conventional ICSI.