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常规体外受精与卵胞浆内单精子注射的机遇与局限:是时候表明立场了。

Opportunities and Limits of Conventional IVF versus ICSI: It Is Time to Come off the Fence.

作者信息

Balli Martina, Cecchele Anna, Pisaturo Valerio, Makieva Sofia, Carullo Giorgia, Somigliana Edgardo, Paffoni Alessio, Vigano' Paola

机构信息

Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.

Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy.

出版信息

J Clin Med. 2022 Sep 27;11(19):5722. doi: 10.3390/jcm11195722.

Abstract

Conventional IVF (c-IVF) is one of the most practiced assisted reproductive technology (ART) approaches used worldwide. However, in the last years, the number of c-IVF procedures has dropped dramatically in favor of intracytoplasmic sperm injection (ICSI) in cases of non-male-related infertility. In this review, we have outlined advantages and disadvantages associated with c-IVF, highlighting the essential steps governing its success, its limitations, the methodology differences among laboratories and the technical progress. In addition, we have debated recent insights into fundamental questions, including indications regarding maternal age, decreased ovarian reserve, endometriosis, autoimmunity, single oocyte retrieval-cases as well as preimplantation genetic testing cycles. The "overuse" of ICSI procedures in several clinical situations of ART has been critically discussed. These insights will provide a framework for a better understanding of opportunities associated with human c-IVF and for best practice guidelines applicability in the reproductive medicine field.

摘要

常规体外受精(c-IVF)是全球应用最广泛的辅助生殖技术(ART)方法之一。然而,在过去几年中,在非男性相关不孕症病例中,c-IVF程序的数量急剧下降,转而青睐卵胞浆内单精子注射(ICSI)。在本综述中,我们概述了与c-IVF相关的优缺点,强调了决定其成功的关键步骤、其局限性、实验室之间的方法差异以及技术进展。此外,我们还讨论了对一些基本问题的最新见解,包括关于产妇年龄、卵巢储备减少、子宫内膜异位症、自身免疫、单卵母细胞采集病例以及植入前基因检测周期的指征。我们还对ICSI程序在ART的几种临床情况下的“过度使用”进行了批判性讨论。这些见解将为更好地理解人类c-IVF相关的机会以及生殖医学领域最佳实践指南的适用性提供一个框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4476/9572455/24c2b7216617/jcm-11-05722-g001.jpg

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