GELECEK The Center For Human Reproduction, Caglayan Mh Bulent Ecevit Bulvari No: 167, Lara, Antalya, Turkey.
Department of Gynecology and Obstetrics, SBU Istanbul Bagcilar Training and Reseach Hospital, İstanbul, Turkey.
Arch Gynecol Obstet. 2022 Aug;306(2):493-499. doi: 10.1007/s00404-022-06471-x. Epub 2022 Feb 27.
We aimed to analyse our clinical results for a particular subgroup of patients with poor ovarian response (POR) to clarify if lower number of oocytes is a drawback for proceeding to C-IVF.
In this retrospective study, patient files of all couples (#1733) who underwent oocyte retrieval between January 2017 and December 2019 were reviewed and 191 cases diagnosed with non-male factor infertility in which ≤ 3 cumulus-oocyte complexes available for fertilisation were analysed. Exclusion criteria were: woman age > 42, patients with a history of previous ART trial, prenatal genetic testing cycles and couples undergoing total cryopreservation for any indication. Three groups were constructed depending on the method of fertilisation and on semen quality as follows: IVF non-male factor (Group 1, n = 77); ICSI non-male factor (Group 2, n = 65); ICSI male factor-ICSI/MF n = 49 according to WHO reference values. Main outcome parameters were: fertilisation rate, implantation rate and live birth rate.
Fertilisation rate per collected COC was significantly higher in group 1 compared to the other two groups (85.68%, 72.58%, 73.33% respectively, p = 0.004). FR per inseminated oocyte also tended to be higher in group 1 but not reaching a statistically significant level. Both techniques yielded similar implantation rates (20.42%, 28.49%, 23.33% respectively, p = 0.407) and live birth rates (26.8%, 30.6%, 31.1%, respectively, p = 0.643).
In the presence of normal semen parameters, low egg number is not an indication to perform ICSI. The choice of fertilisation method should be based primarily on semen quality, in combination with the patient's previous history regardless of the ovarian reserve.
我们旨在分析特定的卵巢低反应（POR）患者亚组的临床结果，以明确卵母细胞数量较少是否会影响继续进行胞浆内单精子注射（ICSI）-常规体外受精（C-IVF）。
在这项回顾性研究中，回顾了 2017 年 1 月至 2019 年 12 月期间接受卵母细胞采集的所有夫妇（#1733 对）的患者档案，分析了 191 例诊断为非男性因素不孕且受精时可用的卵丘-卵母细胞复合物（cumulus-oocyte complexes，COC）≤3 个的病例。排除标准为：女性年龄>42 岁、有之前辅助生殖技术（assisted reproductive technology，ART）试验史、产前遗传检测周期和因任何原因进行全面冷冻保存的夫妇。根据受精方法和精液质量，将患者分为三组：非男性因素 IVF（第 1 组，n=77）；非男性因素 ICSI（第 2 组，n=65）；根据世界卫生组织（World Health Organization，WHO）参考值，ICSI 男性因素-ICSI/MF（n=49）。主要观察指标为：受精率、种植率和活产率。
第 1 组每枚采集的 COC 的受精率明显高于其他两组（分别为 85.68%、72.58%和 73.33%，p=0.004）。第 1 组每枚授精卵的 FR 也倾向于更高，但未达到统计学显著水平。两种技术的种植率（分别为 20.42%、28.49%和 23.33%，p=0.407）和活产率（分别为 26.8%、30.6%和 31.1%，p=0.643）相似。
在正常精液参数的情况下，卵母细胞数量少不是进行 ICSI 的指征。受精方法的选择应主要基于精液质量，并结合患者的既往史，而与卵巢储备无关。
