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正常精子形态率(NSMR)对超短方案 GnRH-a 中临床结局及受精方式选择的影响

Effect of normal sperm morphology rate (NSMR) on clinical outcomes and fertilization methods selection in the ultra-short-term GnRH-a protocol.

作者信息

Li Mingzhao, Ma Chun, Xue Xia, Zhao Wanqiu, Zhang Silin, Shi Juanzi

机构信息

a The ART Center, Northwest Women's and Children's Hospital , Xi'an , China.

出版信息

Gynecol Endocrinol. 2016;32(2):120-3. doi: 10.3109/09513590.2015.1092514. Epub 2015 Oct 6.

Abstract

PURPOSE

To investigate whether intracytoplasmic sperm injection (ICSI) can improve the clinical outcomes of the male patients with teratozoospermia in the ultra-short term GnRH-a protocol.

METHODS

Based on different normal sperm morphology rate (NSMR), the patients were divided into three groups as follows: NSMR = 0% group, 1% ≤NSMR <4% group and NSMR ≥4% group. Each group was compared with two fertilization type of in-vitro fertilization (IVF) and ICSI separately. Main outcomes compared were normal fertilization, high-quality embryo, transferrable embryo, implantation, pregnancy and abortion rate.

RESULTS

We observed that the total clinical pregnancy rate in single cleavage-stage embryo transfer (SET) group was significantly lower compared with double cleavage-stage embryo transfer (DET) group (23.87% versus 40.08%; p < 0.001). There was no significant difference in the aspects of female age, endometrial thickness, infertility duration and the number of retrieved oocytes among three groups (p > 0.05). The normal fertilization, high-quality embryo, transferrable embryo, implantation, pregnancy and abortion rate of IVF and ICSI showed no significant difference among three groups (p > 0.05).

CONCLUSION

ICSI cannot improve clinical outcomes of the patients with teratozoospermia in the ultra-short term GnRH-a protocol.

摘要

目的

探讨在超短方案促性腺激素释放激素激动剂(GnRH-a)中,卵胞浆内单精子注射(ICSI)能否改善畸形精子症男性患者的临床结局。

方法

根据正常精子形态率(NSMR)不同,将患者分为以下三组:NSMR = 0%组、1%≤NSMR<4%组和NSMR≥4%组。每组分别比较体外受精(IVF)和ICSI两种受精方式。比较的主要结局指标为正常受精、优质胚胎、可移植胚胎、着床、妊娠及流产率。

结果

我们观察到,单卵裂期胚胎移植(SET)组的总临床妊娠率显著低于双卵裂期胚胎移植(DET)组(23.87%对40.08%;p<0.001)。三组患者在女性年龄、子宫内膜厚度、不孕时间及获卵数方面无显著差异(p>0.05)。IVF和ICSI的正常受精、优质胚胎、可移植胚胎、着床、妊娠及流产率在三组间无显著差异(p>0.05)。

结论

在超短方案GnRH-a中,ICSI不能改善畸形精子症患者的临床结局。

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