在冻融胚胎移植周期中,胚胎移植的授精方法对非男性因素不孕夫妇的生殖结局没有影响。
Insemination methods for embryos transferred in frozen-thawed embryo transfer cycles do not impact reproductive outcomes in couples with non-male factor infertility.
作者信息
Zhang Yuchao, Jia Qi, Liu Yanli, Guan Yichun
机构信息
Department of Reproductive Medicine, The Third Affiliated Hospital of Zhengzhou University, No.7 Kangfuqian Street, Erqi, Zhengzhou, 450052, Henan, China.
出版信息
Sci Rep. 2025 Apr 20;15(1):13630. doi: 10.1038/s41598-025-97051-x.
In couples with of non-male factor infertility, prevailing discussions have focused primarily on patients undergoing fresh embryo transfer. However, whether intracytoplasmic sperm injection (ICSI) improves reproductive outcomes in patients with non-male factor infertility undergoing frozen-thawed embryo transfer (FET) treatment remains unclear. This retrospective study analyzed 57,907 cycles from the Human Fertilisation and Embryology Authority. All FET cycles with non-male factor infertility were initially included. The final included cycles were divided into the ICSI and in vitro fertilization (IVF) groups. Primary outcomes include clinical pregnancy rate, live birth rate, and miscarriage rate; secondary outcomes comprised neonatal outcomes such as birthweight, gestational week, and sex. Binary logistic regression analysis was used to investigate the impact of ICSI on the studied population. The overall clinical pregnancy rate and live birth rate were significantly higher in the ICSI group than in the IVF group (29.6% vs. 26.0%, P < 0.001; 21.5% vs. 19.1%, P < 0.001). However, ICSI showed no significant association with clinical pregnancy or live birth [adjusted OR: 1.01 (0.95, 1.05), P = 0.969; 1.05 (0.86, 1.28), P = 0.611] after adjustment for confounders. Furthermore, while ICSI was associated with increased rates of full-term births and normal birthweight in singletons, these associations were attenuated after adjustment. Finally, ICSI exhibited no significant effect on neonatal sex ratio [adjusted OR: 0.91(0.93, 1.01), P = 0.052]. In conclusion, ICSI was not associated with improved clinical or neonatal outcomes in FET cycles with non-male factor infertility.
在非男性因素不孕的夫妇中,目前的讨论主要集中在接受新鲜胚胎移植的患者身上。然而,对于非男性因素不孕患者在接受冻融胚胎移植(FET)治疗时,卵胞浆内单精子注射(ICSI)是否能改善生殖结局仍不清楚。这项回顾性研究分析了来自人类受精与胚胎学管理局的57907个周期。所有非男性因素不孕的FET周期最初都被纳入。最终纳入的周期被分为ICSI组和体外受精(IVF)组。主要结局包括临床妊娠率、活产率和流产率;次要结局包括新生儿结局,如出生体重、孕周和性别。采用二元逻辑回归分析来研究ICSI对研究人群的影响。ICSI组的总体临床妊娠率和活产率显著高于IVF组(29.6%对26.0%,P<0.001;21.5%对19.1%,P<0.001)。然而,在对混杂因素进行调整后,ICSI与临床妊娠或活产无显著关联[调整后的OR:1.01(0.95,1.05),P = 0.969;1.05(0.86,1.28),P = 0.611]。此外,虽然ICSI与单胎足月分娩率和正常出生体重率的增加有关,但在调整后这些关联减弱。最后,ICSI对新生儿性别比例无显著影响[调整后的OR:0.91(0.93,1.01),P = 0.052]。总之,在非男性因素不孕的FET周期中,ICSI与改善临床或新生儿结局无关。