卵细胞胞质内单精子注射对 体外受精能力缺陷的改善

第11卷　第12期中华男科学杂志Vol.11　No.12 2005年12月Nati onal Journal of Andr ol ogy Dec.2005

・论著・卵细胞胞质内单精子注射对

体外受精能力缺陷的改善

蔡令波,冯　婷,陈　娟,钱　云,刘嘉茵,张　燕

(南京医科大学第一附属医院生殖医学中心,江苏南京210029)

摘要:　目的:评价前一周期行体外受精(I V F)失败和受精率低后,改行卵细胞胞质内单精子注射(I CSI)的受精效果。　方法:行I CSI治疗的113例患者136周期分为两组:因严重少弱精子症而行I CSI的106个周期(组1);因前次常规I V F受精失败或受精率低于20%而改行I CSI的30个周期(组2)。比较两组间卵母细胞的正常受精率、优质胚胎率和妊娠率的差异,并对第2组受精率的分布进行分析,以了解改行I CSI后受精效果的改善情况。　结果:改行I CSI后,两组的正常受精率和优质胚胎率差异均无显著性(70.49%vs72.02%;38.28%vs38.81%)(P>

0.05)。两组的临床妊娠率分别为40.57%和40.00%,差异也无显著性(P>0.05)。改行I CSI后,大部分周期

(70.00%,21/30)的受精率都在50%以上,平均受精率为79.79%,受精效果得到明显改善。　结论:I V F受精失败

和受精率低可以通过行I CSI而获得较好结局。

关键词:不育;体外受精;受精率低;受精失败;卵细胞胞质内单精子注射

中图分类号:R711.6 文献标识码:A 文章编号:100923951(2005)1220895203

I ntracytoplas m ic Sperm I njection Can I m prove the Fertilization L i m itation Followi n g in vitro

Fertilization duri n g Previous Cycles

CA IL ing2bo,FENG Ting,CHEN Juan,Q I A N Yun,L I U J ia2yin,ZHANG Yan

Repr oductiveM edicine Center,the Fir st Affiliated Hospital of N anjing M edical Univer sity,N anjing,J iangsu210029,China Correspondence to:Q I AN Yun,E2m a il:qianyun@nj m

Abstract:　O bjective:T o evaluate whether or not intracyt op las m ic s per m injecti on(I CSI)can i m p r ove p revi ous fertilizati on li m itati on on conventi onal in vitro fertilizati on(I V F).　M ethods:One hundred and thirty2six comp leted cycles in113patients with I CSI treat2 ment were gr ouped.Gr oup1was106cycles perfor m I CSI because of male fact or,and gr oup2was other30cycles with the hist ory of fertilizati on failure and fertilizati on rate<20%on conventi onal I V F,als o asse mbling the cycles in gr oup2according t o the fertilizati on rate.　R esu lts:There was no significant difference bet w een t w o gr oup s in the rates of nor mal fertilizati on(70.49%vs72.02%),good quality e mbryos(38.28%vs38.81%),and clinical p regnancy(40.57%vs40.00%)(P>0.05).The fertilizati on rate of a maj ori2 ty of cycles(70.00%,21/30)in gr oup2was higher than50%,and the mean of fertilizati on rates was79.79%.　C onclusion:I CSI can i m p r ove the fertilizati on li m itati on f oll owing I V F during p revi ous cycles,and the fertilizati on rates was si m ilar t o those treated I CSI because of male fact or.　N a tl J A ndrol,2005,11(12):8952896,899

Key words:in vitro fertilizati on;l ow fertilizati on rate;fertilizati on failure;intracyt op las m ic s per m injecti on

在实施常规体外受精(I V F)治疗的周期中,5%～10%的患者会出现受精率低于20%或完全不受精的情况。对于这些患者,临床上一般会在下一个周期采用卵细胞胞质内单精子注射(I CSI)技术进行

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收稿日期:2005204202;修回日期:2005208225

基金项目:江苏省科技厅社会发展基金(BS2003045),江苏省卫生厅生殖医学135重点学科基金作者简介:蔡令波(19762),男,山东梁山县人,实习研究员,硕士,从事生殖医学研究。

通讯作者:钱　云,E2mail:qianyun@nj m