Jun Sunny H, O'Leary Thomas, Jackson Katharine V, Racowsky Catherine
Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA.
Fertil Steril. 2006 Oct;86(4):825-9. doi: 10.1016/j.fertnstert.2006.03.043. Epub 2006 Sep 11.
To test the hypothesis that intracytoplasmic sperm injection (ICSI) overcomes a high incidence of tripronucleate zygotes resulting from standard insemination in a previous cycle.
A retrospective analysis of matched-pair cycles.
Assisted reproductive technologies (ART) program of Brigham and Women's Hospital.
PATIENT(S): Ninety-five patients with a > or = 20% incidence of tripronucleate zygotes in an IVF cycle with use of ICSI in a subsequent attempt.
INTERVENTION(S): Cycles with either standard insemination or ICSI.
MAIN OUTCOME MEASURE(S): Incidence of diploid (2pn) and triploid (3pn) zygotes and number and quality of embryos obtained.
RESULT(S): Patient age, ampules of gonadotropin used, peak E2, number of follicles at hCG trigger, and total number of oocytes were all significantly higher in the ICSI cycles, but the number of mature oocytes did not differ. After ICSI, the percentage of 2pn was higher (65.0% vs. 34.1%) and the percentage of 3pn was lower (5.0% vs. 33.9%) than after IVF, and more diploid embryos were obtained with ICSI (5.5 +/- 3.7 vs. 3.4 +/- 2.2 [mean +/- SD]). There was no difference in embryo quality between the two groups.
CONCLUSION(S): ICSI appears beneficial in women with a high 3pn occurrence from IVF because it increases the number of diploid zygotes without affecting embryo quality.
验证以下假设，即胞浆内单精子注射（ICSI）可克服前一周期标准授精导致的三原核受精卵高发生率。
配对周期的回顾性分析。
布莱根妇女医院辅助生殖技术（ART）项目。
95例在体外受精（IVF）周期中三原核受精卵发生率≥20%的患者，随后尝试使用ICSI。
标准授精或ICSI周期。
二倍体（2pn）和三倍体（3pn）受精卵的发生率以及获得的胚胎数量和质量。
ICSI周期中的患者年龄、使用的促性腺激素安瓿数、E2峰值、hCG触发时的卵泡数和卵母细胞总数均显著更高，但成熟卵母细胞数量无差异。与IVF后相比，ICSI后2pn的百分比更高（65.0%对34.1%），3pn的百分比更低（5.0%对33.9%），且ICSI获得的二倍体胚胎更多（5.5±3.7对3.4±2.2[平均值±标准差]）。两组间胚胎质量无差异。
对于IVF后3pn发生率高的女性，ICSI似乎有益，因为它可增加二倍体受精卵数量且不影响胚胎质量。
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