Kim Howard H, Bundorf M Kate, Behr Barry, McCallum Stewart W
Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Fertil Steril. 2007 Sep;88(3):622-8. doi: 10.1016/j.fertnstert.2006.12.013. Epub 2007 Apr 18.
To determine whether intracytoplasmic sperm injection (ICSI) is associated with improved outcomes for non-male factor infertility.
We examined the patient characteristics associated with treatment choice-ICSI and conventional in vitro fertilization (IVF)-among patients without a diagnosis of male factor infertility and compared outcomes between the two groups, adjusting for patient characteristics using multivariate regression models.
Academic fertility center.
PATIENT(S): We evaluated 696 consecutive assisted reproductive technology (ART) cycles performed for couples with normal semen analysis at the Stanford Reproductive Endocrinology and Infertility Center between 2002 and 2003. We compared patient characteristics, cycle details, and outcomes for ICSI and IVF.
MAIN OUTCOME MEASURE(S): Fertilization, pregnancy, and live birth rates.
RESULT(S): Patient characteristics were similar between the two groups, except the proportion of patients with unexplained infertility (IVF 15.1% vs. ICSI 23.5%), previous fertility (IVF 62.6% vs. ICSI 45.5%), and previous ART cycle (IVF 41.2% vs. ICSI 67.7%). More oocytes were fertilized per cycle for the IVF group (6.6 oocytes versus 5.1 oocytes). Fertilization failure, pregnancy, and live birth rates did not differ between IVF and ICSI. Using logistic regressions, having had previous ART was found to be positively associated with ICSI. Treatment choice of ICSI was not associated with fertilization, pregnancy, or live birth rates.
CONCLUSION(S): No clear evidence of improved outcomes with ICSI was demonstrated for non-male factor infertility.
确定卵胞浆内单精子注射（ICSI）是否与非男性因素不孕症的改善结局相关。
我们研究了未诊断为男性因素不孕症的患者中与治疗选择（ICSI和传统体外受精[IVF]）相关的患者特征，并比较了两组的结局，使用多变量回归模型对患者特征进行了调整。
学术性生育中心。
我们评估了2002年至2003年间在斯坦福生殖内分泌与不孕症中心为精液分析正常的夫妇进行的696个连续辅助生殖技术（ART）周期。我们比较了ICSI和IVF的患者特征、周期细节和结局。
受精率、妊娠率和活产率。
两组患者的特征相似，但不明原因不孕症患者的比例（IVF为15.1%，ICSI为23.5%）、既往生育情况（IVF为62.6%，ICSI为45.5%）和既往ART周期（IVF为41.2%，ICSI为67.7%）除外。IVF组每个周期受精的卵母细胞更多（6.6个卵母细胞对5.1个卵母细胞）。IVF和ICSI之间的受精失败率、妊娠率和活产率没有差异。使用逻辑回归分析发现，既往进行过ART与ICSI呈正相关。ICSI的治疗选择与受精率、妊娠率或活产率无关。
对于非男性因素不孕症，没有明确证据表明ICSI能改善结局。
