Eftekhar Maryam, Mohammadian Farnaz, Yousefnejad Fariba, Molaei Behnaz, Aflatoonian Abbas
Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Azadi Avenue, Zanjan, Iran.
Iran J Reprod Med. 2012 Mar;10(2):131-6.
Conventional IVF and ICSI are two common techniques to achieve fertilization. IVF has long been used for treatment of infertility, although it is not an effective treatment in severe male infertility. The use of ICSI has been expanded in severe male factor and fertilization failure after IVF cycle. In spite of the widespread use of ICSI in patients with non-male factor infertility, there is still little evidence to confirm its effectiveness in this population.
To evaluate assisted reproductive technology outcomes between IVF and ICSI cycles in non-male factor, normoresponder patients.
A total of 220 non-male factors, normoresponder patients who were indicated for ART were enrolled in this study. The patients received standard long GnRH agonist or GnRH antagonist protocols for ovarian stimulation and after oocytes retrieval, the patients were divided into two groups (IVF and ICSI groups). In IVF group (n=112), all of retrieved oocytes were treated by conventional IVF and in ICSI group (n=88), microinjection (ICSI) was done on all of retrieved oocytes.
In IVF group, fertilization and implantation rates were significantly higher than ICSI group (66.22% and 16.67% in IVF group versus 57.46% and 11.17% in ICSI group, respectively). Chemical and clinical pregnancy rates were statistically higher in IVF group as compared with the ICSI group (42.9% vs. 27.3% and 35.7% vs. 21.5%, respectively).
According to our study, the routine use of ICSI is not improved fertilization, implantation and chemical pregnancy rates and is not recommended in non-male factor, normozoospermic patients.
传统体外受精(IVF)和卵胞浆内单精子注射(ICSI)是实现受精的两种常用技术。IVF长期以来一直用于治疗不孕症,尽管它对严重男性不育症并非有效治疗方法。ICSI的应用已在严重男性因素及IVF周期受精失败的情况下得到扩展。尽管ICSI在非男性因素不孕症患者中广泛使用,但仍缺乏证据证实其在该人群中的有效性。
评估非男性因素、反应正常患者中IVF和ICSI周期的辅助生殖技术结局。
本研究共纳入220例因辅助生殖技术(ART)就诊的非男性因素、反应正常患者。患者接受标准长效促性腺激素释放激素(GnRH)激动剂或GnRH拮抗剂方案进行卵巢刺激,取卵后,患者被分为两组(IVF组和ICSI组)。IVF组(n = 112),所有取出的卵母细胞采用传统IVF处理;ICSI组(n = 88),对所有取出的卵母细胞进行显微注射(ICSI)。
IVF组的受精率和着床率显著高于ICSI组(IVF组分别为66.22%和16.67%,ICSI组分别为57.46%和11.17%)。IVF组的生化妊娠率和临床妊娠率在统计学上高于ICSI组(分别为42.9%对27.3%和35.7%对21.5%)。
根据我们的研究,常规使用ICSI并不能提高受精率、着床率和生化妊娠率,不建议在非男性因素、精子正常的患者中使用。