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常规体外受精与卵胞浆内单精子注射治疗中度射精障碍男性不育症的疗效比较。

Comparison of the outcome of conventional in vitro fertilization and intracytoplasmic sperm injection in moderate male infertility from ejaculate.

作者信息

Xie Bao-Guo, Huang Yuan-Hua, Zhu Wei-Jie, Jin Song

机构信息

Reproductive Medicine Centre, The Affiliated Hospital of Hainan Medical College, Haikou, PR China.

出版信息

Urol Int. 2015;94(1):111-6. doi: 10.1159/000353975. Epub 2013 Nov 13.

Abstract

OBJECTIVE

To evaluate whether couples with moderate male infertility should be treated with conventional in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

PATIENTS AND METHODS

A total of 249 couples with moderate male infertility undergoing their first IVF/ICSI cycle were enrolled in the study. The couples were divided into two groups according to the results of semen analysis: moderate oligozoospermia (O group) and moderate oligoasthenozoospermia (OA group). Sibling oocytes were randomized into groups to be inseminated either by conventional IVF or ICSI. Fertilization rate, embryo quality, implantation rate, and clinical pregnancy rate were examined.

RESULTS

There was no difference in the fertilization, implantation, and pregnancy rates between conventional IVF and ICSI in either the O group or OA group (p > 0.05). Additionally, in the OA group, the good quality embryo rate was similar after IVF or ICSI (p > 0.05). However, in the O group, the good quality embryo rate was significantly higher after ICSI than after IVF (p < 0.05).

CONCLUSIONS

Couples with moderate oligozoospermia or moderate oligoasthenozoospermia did not influence the major indices of IVF. Because of the uncertainties concerning the safety of ICSI, couples with moderate oligozoospermia or moderate oligoasthenozoospermia need not be subjected to this procedure.

摘要

目的

评估患有中度男性不育症的夫妇应接受常规体外受精(IVF)还是卵胞浆内单精子注射(ICSI)治疗。

患者与方法

共有249对患有中度男性不育症且正在进行首次IVF/ICSI周期治疗的夫妇纳入本研究。根据精液分析结果将这些夫妇分为两组:中度少精子症(O组)和中度少弱精子症(OA组)。将同胞卵母细胞随机分组,分别采用常规IVF或ICSI进行授精。检查受精率、胚胎质量、着床率和临床妊娠率。

结果

在O组和OA组中,常规IVF与ICSI的受精率、着床率和妊娠率均无差异(p>0.05)。此外,在OA组中,IVF或ICSI后的优质胚胎率相似(p>0.05)。然而,在O组中,ICSI后的优质胚胎率显著高于IVF后(p<0.05)。

结论

患有中度少精子症或中度少弱精子症的夫妇不会影响IVF的主要指标。由于ICSI安全性存在不确定性,患有中度少精子症或中度少弱精子症的夫妇无需接受该治疗。

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