Jeve Yadava Bapurao, Potdar Neelam, Blower Jane A, Gelbaya Tarek
a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK.
b Reproductive Sciences Section , University of Leicester , Leicester , UK.
Hum Fertil (Camb). 2018 Dec;21(4):229-247. doi: 10.1080/14647273.2017.1324182. Epub 2017 May 26.
Successful fertilisation is one of the key steps determining success of assisted conception. Various factors including sperm or oocyte pathology and environmental factors have a significant impact on fertilisation rates. This systematic review is aimed to evaluate the existing evidence about factors affecting fertilisation and strategies to improve fertilisation rates. A literature search was performed using Ovid MEDLINE ® (Jan 1950-April 2016), EMBASE (Jan 1950-April 2016), Ovid OLDMEDLINE ®, Pre-MEDLINE (Jan 1950-April 2016) and the Cochrane Library. Relevant key words were used to combine sets of results and a total 243 papers were screened. Only qualitative analysis was performed, as there was major heterogeneity in study design and methodology for quantitative synthesis. Factors affecting fertilisation were divided into sperm- and oocyte-related factors. The methods to improve fertilisation rates were grouped together based on the approach used to improve fertilisation rates. Optimising laboratory condition and procedural effects in techniques is associated with improved fertilisation rates. Various techniques are described to improve fertilisation rates including assisted oocyte activation, physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic morphologically selected sperm injection (IMSI). This review highlights the promising strategies under research to enhance fertilisation rates. Adequately powered multicentre randomised trials are required to evaluate these techniques before considering clinical application.
成功受精是决定辅助受孕成功与否的关键步骤之一。包括精子或卵子病理以及环境因素在内的多种因素对受精率有重大影响。本系统综述旨在评估有关影响受精的因素及提高受精率策略的现有证据。使用Ovid MEDLINE®（1950年1月至2016年4月）、EMBASE（1950年1月至2016年4月）、Ovid OLDMEDLINE®、Pre-MEDLINE（|950年1月至2016年4月）和考科蓝图书馆进行文献检索。使用相关关键字合并结果集，共筛选出243篇论文。由于研究设计和定量合成方法存在重大异质性，因此仅进行了定性分析。影响受精的因素分为与精子和卵子相关的因素。根据提高受精率所采用的方法，将提高受精率的方法归为一组。优化实验室条件和技术操作效果与提高受精率相关。描述了多种提高受精率的技术，包括辅助卵子激活、生理性卵胞浆内单精子注射（PICSI）和形态学选择的卵胞浆内单精子注射（IMSI）。本综述强调了正在研究的提高受精率的有前景的策略。在考虑临床应用之前，需要进行足够样本量的多中心随机试验来评估这些技术。
