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确定在常规体外受精周期中部分受精失败时进行补救性卵胞浆内单精子注射的必要性。

Determining the need for rescue intracytoplasmic sperm injection in partial fertilisation failure during a conventional IVF cycle.

作者信息

Cao S, Wu X, Zhao C, Zhou L, Zhang J, Ling X

机构信息

State Key Laboratory of Reproductive Medicine, Department of Reproduction, Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Andrologia. 2016 Dec;48(10):1138-1144. doi: 10.1111/and.12551. Epub 2016 Feb 29.

Abstract

To explore the need for rescue intracytoplasmic sperm injection (ICSI) in cases of partial fertilisation failure during a conventional in vitro fertilisation cycle, rescue ICSI was performed for cycles with a fertilisation rate of <50%. The data were divided into three groups based on the fertilisation rate: group 1 (0%), group 2 (<25%) and group 3 (>25%). The impact of rescue ICSI on each group was then analysed in terms of ovum fertilisation, embryo development, embryo utilisation and selection of embryos for transfer. Rescue ICSI was performed on 1831 unfertilised oocytes from 313 cycles. The fertilisation rates for group 1, group 2 and group 3 were 74.66, 68.35 and 65.46%, and the rate of polyploidy in the three groups was 8.55, 11.33, and 14.47%. The percentage of embryos that can be transferred from rescue ICSI for group 2 was 38.33%, and this value was higher than those of the other two groups. It is concluded that rescue ICSI is not recommended for patients with an IVF rate of >25% as the procedure is associated with a greater risk and low returns. However, it is feasible to perform rescue ICSI for patients with IVF rates of <25%.

摘要

为探讨在常规体外受精周期中部分受精失败病例行补救性卵胞浆内单精子注射(ICSI)的必要性,对受精率<50%的周期进行补救性ICSI。根据受精率将数据分为三组:第1组(0%)、第2组(<25%)和第3组(>25%)。然后从卵子受精、胚胎发育、胚胎利用及胚胎移植选择等方面分析补救性ICSI对每组的影响。对313个周期的1831枚未受精卵子进行了补救性ICSI。第1组、第2组和第3组的受精率分别为74.66%、68.35%和65.46%,三组的多倍体率分别为8.55%、11.33%和14.47%。第2组补救性ICSI后可用于移植的胚胎百分比为38.33%,该值高于其他两组。结论是,对于体外受精率>25%的患者不建议行补救性ICSI,因为该操作风险较高且回报较低。然而,对于体外受精率<25%的患者行补救性ICSI是可行的。

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