Orief Yasser, Dafopoulos Konstantinos, Al-Hassani Safaa
Department of Obstetrics and Gynecology, Shatby University Hospital, Alexandria University, Egypt.
Reprod Biomed Online. 2004 Sep;9(3):348-56. doi: 10.1016/s1472-6483(10)62152-9.
There is general agreement that intracytoplasmic sperm injection (ICSI) should be used in male factor infertility cases, such as oligoasthenoteratozoospermia, presence of anti-sperm antibodies, or azoospermia, these cases being diagnosed through abnormal semen analysis. There are no randomized clinical trials comparing ICSI with IVF (or other interventions) where semen quality is so poor that IVF would not achieve fertilization. It is accepted that ICSI is the only treatment option in those circumstances. The role of ICSI where IVF can be expected to give a reasonable fertilization rate is the question that needs to be answered. The argument is whether or not ICSI should be used for all cases of infertility. This paper proposes and strongly supports the use of ICSI for all indications. Considerations of fertilization and embryo development, cost effectiveness and safety will be clearly discussed.
人们普遍认为，卵胞浆内单精子注射（ICSI）应用于男性因素导致的不孕症病例，如少弱畸精子症、抗精子抗体的存在或无精子症，这些病例通过异常精液分析得以诊断。目前尚无随机临床试验比较ICSI与体外受精（IVF）（或其他干预措施）在精液质量极差以至于IVF无法实现受精的情况下的效果。人们公认，在这些情况下ICSI是唯一的治疗选择。在IVF有望获得合理受精率的情况下ICSI的作用是一个需要回答的问题。争论点在于ICSI是否应用于所有不孕症病例。本文提出并强烈支持将ICSI用于所有适应症。将对受精和胚胎发育、成本效益及安全性等方面进行清晰的讨论。
