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完全受精失败:单中心分析。

Total Fertilization Failure: A Single Center Analysis.

机构信息

Insemine Center for Human Reproduction, Porto Alegre, Brazil.

出版信息

Reprod Sci. 2024 Mar;31(3):697-703. doi: 10.1007/s43032-023-01338-1. Epub 2023 Oct 9.

Abstract

Our main objective was to identify the male and female parameters associated with total fertilization failure (TFF) in IVF with nonmasculine indications. The present work, IRB equivalent INS 63209, is a case-control study that evaluated all cases with TFF after conventional IVF at the Center for Human Reproduction from January 2010 to December 2019 (n = 154). As a control group, we analyzed all patients who did not experience fertilization failure after conventional IVF in the same period (n = 475). We evaluated various parameters, both male and female, assessed during infertility treatment, and only cases without masculine etiology (normal seminal parameters) were included. Ages (female and male) were not different between the groups. Moreover, AMH (anti-Müllerian hormone), semen volume, preprocessing concentration and preprocessing motility were not significantly different (P > 0.05). However, the number of collected oocytes (study versus control groups, median [25-75 interquartile]: 2 [1-5] and 5 [3-8]); MII (2 [1-4] and 5 [2-7]); and postprocessing motility (85 [70-90] and 90 [80-95]) were significantly different between both groups (P < 0.05). Furthermore, a logistic regression analysis including all significant data demonstrated that the number of collected oocytes was significantly related to IVF failure. Patients with fewer than 5 oocytes had an OR of - 1.37 (- 0.938 to - 1.827) for TFF after conventional IVF. Our results showed that a lower follicular response to controlled ovarian stimulation, evidenced by a decreased number of collected oocytes, was the most important parameter associated with IVF failure in nonmasculine infertility.

摘要

我们的主要目标是确定非男性指征的体外受精中总受精失败(TFF)相关的男性和女性参数。本研究(等效于 INS 63209 的 IRB)为病例对照研究,评估了 2010 年 1 月至 2019 年 12 月期间在人类生殖中心接受常规体外受精后出现 TFF 的所有病例(n=154)。作为对照组,我们分析了同期常规体外受精未发生受精失败的所有患者(n=475)。我们评估了不孕治疗期间的各种参数,且仅纳入无男性病因(正常精液参数)的病例。两组的年龄(女性和男性)无差异。此外,抗苗勒管激素(AMH)、精液量、预处理浓度和预处理活力无显著差异(P>0.05)。然而,两组间采集的卵母细胞数量(研究组与对照组,中位数[25-75 四分位距]:2[1-5]和 5[3-8])、MII 期卵母细胞数量(2[1-4]和 5[2-7])和处理后活力(85[70-90]和 90[80-95])存在显著差异(P<0.05)。此外,包括所有显著数据的逻辑回归分析表明,采集的卵母细胞数量与体外受精失败显著相关。与常规体外受精后 TFF 相关的卵母细胞数少于 5 个的患者的 OR 为-1.37(95%CI:-0.938 至-1.827)。我们的结果表明,控制性卵巢刺激下卵泡反应较差,表现为采集的卵母细胞数量减少,是与非男性不育中体外受精失败相关的最重要参数。

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