Check M L, Katsoff D, Check J H, Swenson K
The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, USA.
Arch Androl. 2000 Jan-Feb;44(1):41-5. doi: 10.1080/014850100262399.
A recent study suggested that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion (SAB) after in vitro fertilization-embryo transfer (IVF-ET). However, IVF-ET with intracytoplasmic sperm injection (ICSI) did not seem to be associated with an increased SAB rate. The study presented herein compared the rate of SAB in pregnancies achieved by IVF-ET according to the type of oocyte insemination process. The 3 types evaluated were conventional insemination, which exposed the oocyte to 25,000 sperm with prolonged contact (16-24 h), intermediate contact with a short insemination protocol where contact with 25,000 sperm was limited to 2 h, and very limited contact with ICSI, where only 1 sperm was injected into the oocyte thus not exposing the zona pellucida to any sperm. The patients were further subdivided into age groups of < or =39 or > or =40. SAB rates after frozen ET were also evaluated. The clinical pregnancy and SAB rates following fresh or frozen ET for conventional, ICSI, and short insemination techniques for the 2 age groups were comparable. These data question whether oligoasthenozoospermia may be a factor in causing SAB, and whether avoidance of contact with the zona pellucida by using ICSI can negate this effect. A larger study is needed.
最近的一项研究表明，少弱精子症可能是体外受精-胚胎移植（IVF-ET）后自然流产（SAB）的一个病因。然而，卵胞浆内单精子注射（ICSI）的IVF-ET似乎与SAB率增加无关。本文介绍的这项研究根据卵母细胞授精过程的类型比较了IVF-ET获得妊娠后的SAB率。评估的3种类型为：传统授精，使卵母细胞与25000个精子长时间接触（16 - 24小时）；中间接触，采用短授精方案，与25000个精子的接触限于2小时；以及与ICSI的接触非常有限，即仅将1个精子注入卵母细胞，因此透明带不与任何精子接触。患者进一步分为年龄小于或等于39岁或大于或等于40岁的年龄组。还评估了冷冻胚胎移植后的SAB率。两个年龄组采用传统授精、ICSI和短授精技术进行新鲜或冷冻胚胎移植后的临床妊娠率和SAB率相当。这些数据质疑少弱精子症是否可能是导致SAB的一个因素，以及通过使用ICSI避免与透明带接触是否可以消除这种影响。需要进行更大规模的研究。
