Jawed Shireen, Rehman Rehana, Ali Mohammad Ashfaq, Abdullah Umme Hani, Gul Hina
Dr. Shireen Jawed, M.Phil Physiology, Assistant Professor of Physiology, Islam Medical & Dental College, Sialkot, Pakistan.
Dr. Rehana Rehman, PhD Physiology, Assistant Professor of Physiology, Aga Khan University, Karachi, Pakistan.
Pak J Med Sci. 2016 Jan-Feb;32(1):3-7. doi: 10.12669/pjms.321.8329.
To identify predictors of fertilization rate in patients of unexplained infertility after intracytoplasmic sperm injection (ICSI).
Retrospective analysis of females (282) enrolled in quasi experimental design for ICSI at "Islamabad Clinic Serving Infertile Couples" was carried out from July 2013 till June 2014. Females with unexplained infertility were included, whereas well defined male and female causes of infertility were excluded. Fertilization rate (FR) was calculated as percentage transformation of micro injected oocytes into two pronuclei. Categorical variable of FR defined on the basis of 50% FR grouped females; Group I with FR ≤50% and Group II with FR >50%. The groups were compared in terms of demographic variables, base line hormones and oocyte parameters. Univariate logistic regression was executed to obtain odds ratio with 95% confidence interval to quantify the association of predictors like age, duration of infertility, oocytes parameters, hormones; Estradiol, progesterone, follicle stimulating hormone (FSH), luteinizing hormone, prolactin and cytokines interleukin-Iβ (IL-Iβ) with the FR.
In our study out of 282 females, 19 (6.73%) were in group I and 263 (93.26%) comprised of Group II. Females with high FR(group II) had low Progesterone and FSH (p=0.04, p=0.02) respectively. Mature oocytes (OR: 0.35; 95% CI 1 - 2.56) and IL-Iβ in follicular phase (OR: 1.04; 95% CI: 0.000- 1.20) were significant positive predictors of FR while peak progesterone and FSH had significant negative effect on it.
Fertilization of oocytes in females of unexplained infertility depended on maturity of oocytes and optimal amounts of ILI- β released by developing follicles in the follicular phase of stimulation cycles of ICSI.
确定不明原因不孕症患者在卵胞浆内单精子注射（ICSI）后受精率的预测因素。
对2013年7月至2014年6月在“伊斯兰堡不孕夫妇诊疗所”参加ICSI准实验设计的282名女性进行回顾性分析。纳入不明原因不孕症的女性，排除明确的男性和女性不孕原因。受精率（FR）计算为显微注射卵母细胞转化为双原核的百分比。根据50%的FR对女性进行分组定义分类变量；第一组FR≤50%，第二组FR>50%。比较两组在人口统计学变量、基线激素和卵母细胞参数方面的差异。进行单因素逻辑回归以获得95%置信区间的比值比，以量化年龄、不孕持续时间、卵母细胞参数、激素（雌二醇、孕酮、促卵泡激素（FSH）、促黄体生成素、催乳素）和细胞因子白细胞介素 - Iβ（IL - Iβ）等预测因素与FR的关联。
在我们的研究中，282名女性中，19名（6.73%）在第一组，263名（93.26%）在第二组。受精率高的女性（第二组）孕酮和FSH水平较低（p = 0.04，p = 0.02）。成熟卵母细胞（OR：0.35；95%CI 1 - 2.56）和卵泡期的IL - Iβ（OR：1.04；95%CI：0.000 - 1.20）是FR的显著正预测因素，而孕酮峰值和FSH对其有显著负影响。
不明原因不孕症女性的卵母细胞受精取决于卵母细胞的成熟度以及ICSI刺激周期卵泡期发育卵泡释放的最佳量的IL - Iβ。
