摘要
目的比较弱畸形精子症(同时患有弱精子症和畸形精子症者)和精液正常患者行常规体外受精(IVF)的受精率和胚胎发育的差异,分析原发性与继发性不育对于弱畸精子症患者IVF受精率的影响,同时分析弱畸精子行分半ICSI(H-ICSI)和早补救ICSI是否改善受精结局,为今后选择合适的治疗方案提供参考。方法将2016年1月至12月在沈阳九州家圆医院生殖医学中心行IVF-胚胎移植(IVF-ET)的患者分为弱畸精子症组(A组)和精液正常组(B组),A组内分为原发不育组(P组)和继发不育组(S组)。分别比较各组间的受精率、2PN受精率、卵裂率、2PN卵裂率、优质胚胎率、临床妊娠率等指标有无显著性差异。结果 A组受精率和2PN受精率显著低于B组(61.23%vs.75.19%,43.05%vs.56.58%,P<0.01),卵裂率、2PN卵裂率、优质胚胎率差异无统计学意义(P>0.05)。P组受精率显著低于S组(56.35%vs.66.37%,P<0.01),妊娠率显著低于S组(33.333%vs.73.33%,P<0.05)。R-ICSI中,ICSI优质胚胎率B组显著高于A组(60.61%vs.39.74%,P<0.01)。结论弱畸精子症显著影响IVF的受精率和2PN受精率,但是不影响后续胚胎发育和妊娠。原发不育的弱畸精子症会显著影响IVF周期中的受精率和临床妊娠率。对于这类患者,在IVF周期中应采取相应的短时受精以防止受精失败和低受精。精子活力和形态对受精和胚胎发育都有重要影响。
Objective To investigate whether both sperm motility and morphology affect in vitro fertilization(IVF)parameters and subsequent embryo development,analyze the differences in IVF parameters and embryo development between primary infertility patients and secondary infertility patients,and investigate whether half-intracytoplasmic sperm injection(ICSI)and rescue-ICSI improves fertilization outcome.Methods Patients who underwent IVF-embryo transfer(ET)at the Reproductive Medicine Center of Shenyang,Jiuzhou Family Hospital from January to December2016were divided into an astheno-teratozoospermia group(group A)and a control group(Group B).Group A were further divided into a primary infertility group(group P)and a secondary infertility group(group S).The differences in fertilization parameters were compered between different groups.Results The fertilization rate and2PN fertilization rate were significantly lower in group A than in group B(61.23%vs.75.19%,43.05%vs.56.58%,P<0.01).No significant differences were observed in cleavage rate,2PN cleavage rate,or good-quality embryo rate between groups A and B.The fertilization rate and clinical pregnancy rate were significantly lower in group P than in group S(56.35%vs.66.37%,P<0.01;33.33%vs.73.33%,P<0.05).The good-quality embryo rate in rescue-ICSI was significantly higher in group B than in group A(60.61%vs.39.74%,P<0.01).Conclusion Although astheno-teratozoospermia can significantly affect IVF rate and2PN fertilization rate,the subsequent embryo development and clinical pregnancy are not significantly affected.Primary astheno-teratozoospermia affects IVF rate and clinical pregnancy rate.Short-term fertilization should be chosen in cases with primary astheno-teratozoospermia to avoid fertilization failure and low filiation rate.Both sperm motility and morphology are important for IVF parameters and subsequent embryo development.
作者
孙绪磊
徐嘉君
冷义福
文江
张学奎
卜英波
马小菊
胡淑敏
Sun Xulei;Xu Jiajun;Leng Yifu;Wen Jiang;Zhang Xuekui;Pu Yingbo;Ma Xiaoju;Hu Shumin(Reproductive Medicine Center of Shenyang,Jiuzhou Family Hospital,Shenyang110014,China)
出处
《中华临床医师杂志（电子版）》
CAS
2017年第13期1978-1981,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
弱畸精子
体外受精
受精率
胚胎发育
Astheno-teratozoospermia
In vitro fertilization
Fertilization rate
Embryo
