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少弱精子症可能是体外受精-胚胎移植后自然流产的一个病因学因素的证据。

Evidence that oligoasthenozoospermia may be an etiologic factor for spontaneous abortion after in vitro fertilization-embryo transfer.

作者信息

Kiefer D, Check J H, Katsoff D

机构信息

Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School at Camden, USA.

出版信息

Fertil Steril. 1997 Sep;68(3):545-8. doi: 10.1016/s0015-0282(97)00235-5.

Abstract

OBJECTIVE

To evaluate whether oligoasthenozoospermia may lead to a higher spontaneous abortion (SAB) rate once a pregnancy is established by IVF-ET.

DESIGN

Retrospective clinical observational study.

SETTING

University-based IVF program.

PATIENT(S): Three hundred sixty-four couples with normal semen parameters who underwent IVF-ET with conventional sperm incubation; 70 couples with oligoasthenozoospermia but without marked abnormal sperm morphology (< 4% normal forms using strict criteria) who underwent ET after IVF with conventional sperm incubation; and 20 couples with oligoasthenozoospermia but without abnormal sperm morphology who underwent ET after IVF with intracytoplasmic sperm injection (ICSI).

MAIN OUTCOME MEASURE(S): Implantation rate, clinical pregnancy rate, SAB rate, and delivery rate after IVF-ET.

RESULT(S): Despite similar pregnancy and implantation rates per ET, as a result of a higher SAB rate (40.0% versus 11.7%), the delivery rates were lower in the female partners of men with oligoasthenozoospermia. Similar patients who used ICSI had a 0% SAB rate.

CONCLUSION(S): Oligoasthenozoospermia should be considered a possible risk factor for SAB in IVF achieved pregnancies. Further studies are needed to determine whether ICSI reduces the risk of SAB associated with oligoasthenozoospermia.

摘要

目的

评估少弱精子症患者经体外受精-胚胎移植(IVF-ET)成功妊娠后,其自然流产(SAB)率是否更高。

设计

回顾性临床观察研究。

地点

大学附属体外受精项目。

患者

364对精液参数正常的夫妇接受了常规精子孵育的IVF-ET;70对少弱精子症但精子形态无明显异常(严格标准下正常形态精子<4%)的夫妇在常规精子孵育的IVF后接受了胚胎移植(ET);20对少弱精子症且精子形态无异常的夫妇在卵胞浆内单精子注射(ICSI)的IVF后接受了ET。

主要观察指标

IVF-ET后的着床率、临床妊娠率、SAB率和分娩率。

结果

尽管每次ET的妊娠率和着床率相似,但由于SAB率较高(40.0%对11.7%),少弱精子症男性的女性伴侣分娩率较低。采用ICSI的类似患者SAB率为0%。

结论

少弱精子症应被视为IVF妊娠中SAB的一个可能危险因素。需要进一步研究以确定ICSI是否能降低与少弱精子症相关的SAB风险。

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