• 四川大學(xué)華西第二醫(yī)院婦產(chǎn)科,四川成都 610041;

目的:探討IVF-ET周期中,對(duì)常規(guī)IVF完全受精失敗的卵子補(bǔ)行卵胞漿內(nèi)單精子注射精子(Rescue ICSI)的臨床應(yīng)用價(jià)值。方法:在常規(guī)IVF后18～22 h,對(duì)體外受精完全失敗的12個(gè)周期、85個(gè)未受精MⅡ期卵行補(bǔ)行ICSI。以同時(shí)期進(jìn)行ICSI的34個(gè)周期、226個(gè)MⅡ期卵為對(duì)照,比較ICSI結(jié)局。結(jié)果:補(bǔ)救ICSI組與對(duì)照組比較,基礎(chǔ)內(nèi)分泌指標(biāo),HCG 日平均血清雌二醇和孕激素水平、子宮內(nèi)膜厚度,獲MⅡ期卵個(gè)數(shù)以及平均移植胚胎個(gè)數(shù),無(wú)顯著性差異。補(bǔ)救ICSI組受精率和卵裂率分別為78.82％、91.04％,與對(duì)照組(受精率為80.09%,卵裂率為95.58%)比較,差異無(wú)統(tǒng)計(jì)學(xué)意義。取卵后第3天,補(bǔ)救ICSI組卵裂球數(shù)≥5的優(yōu)質(zhì)胚胎比例占13.11％,低于對(duì)照ICSI組(73.99％),差異有顯著性 (P lt;0.05)。對(duì)照ICSI組妊娠率為38.24％,補(bǔ)救ICSI組無(wú)一例妊娠。結(jié)論:補(bǔ)行ICSI雖然可使常規(guī)IVF中未受精卵受精并獲得胚胎,但是所得胚胎的發(fā)育潛能差,妊娠率極低,臨床應(yīng)用價(jià)值有限。

引用本文： 黃仲英,李尚為,馬黔紅,耿麗紅,李蕾,李小紅,胡寒,靳松. 常規(guī)體外受精完全失敗后補(bǔ)行卵胞漿內(nèi)單精子注射的應(yīng)用價(jià)值. 華西醫(yī)學(xué), 2009, 24(4): 851-853. doi: 復(fù)制

1. 黃仲英,李尚為,馬黔紅,等. 精子活動(dòng)力對(duì)卵胞漿內(nèi)單精子注射結(jié)局的影響[J]. 生殖與避孕,2006,26(1): 47-48..
2. 莊廣倫主編.現(xiàn)代輔助生育[M]. 第1版, 北京:人民衛(wèi)生出版社,2005: 238-241..
3. CHEN C, KARTRERA S. Rescue ICSI of oocytes that failed to extrude the second polar body 6h post-insemination in conventional IVF[J]. Hum Reprod,2003,18(10):2122-2123..
4. AMARIN Z O, OBEIDATBRTB R, ROUZIA A, et al. Intracyloplasmic sperm injection after total conventional in-vitro fertilization failure[J]. Saudi Med J,2005,26(3):411-415..
5. DEUGARTE C M, LI M, JORDAN B, et al. Rescue intracytoplasmic sperm injection and preimplantation genetic diagnosis in combination can result in pregnancy [J]. Fertil Steril,2006,86(1):200-202..
6. 曾勇,胡曉東,宋成,等.體外受精失敗后補(bǔ)行卵胞漿內(nèi)單精子注射的臨床價(jià)值探討[J].生殖與避孕,2006,26(1):32-34..
7. 李曉虹,于叢一,麥美琪,等.常規(guī)IVF不受精周期行補(bǔ)救卵母細(xì)胞單精子注射[J].中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版),2007,28(2):188-191..
8. FRIEDLER S, RAZIEL A, STRASSBURGER D, et al. Factors influencing the outcome of ICSI in patients with obstructive and non-obstructive azoospermia: a comparative study[J]. Hum Reprod,2002,17(12):3114-3121..
9. PEHLIVAN T, RUBIO C, RUIZ A, et al. Embryonic chromosomal abnormalities obtained after rescue intracytoplasmic sperm injection of 1-day-old unfertilized oocytes [J]. J Assist Reprod Genet,2004,21(2):55-57.〖ZK)〗.
10. NAGY Z P, RIENZI L F, UBALDI F M, et al. Effect of reduced oocyte aging on the outcome of rescue intracytoplasmic sperm injection [J]. Fertil Steril,2006,85(4):901-906..
  1. 1. 黃仲英,李尚為,馬黔紅,等. 精子活動(dòng)力對(duì)卵胞漿內(nèi)單精子注射結(jié)局的影響[J]. 生殖與避孕,2006,26(1): 47-48..
  2. 2. 莊廣倫主編.現(xiàn)代輔助生育[M]. 第1版, 北京:人民衛(wèi)生出版社,2005: 238-241..
  3. 3. CHEN C, KARTRERA S. Rescue ICSI of oocytes that failed to extrude the second polar body 6h post-insemination in conventional IVF[J]. Hum Reprod,2003,18(10):2122-2123..
  4. 4. AMARIN Z O, OBEIDATBRTB R, ROUZIA A, et al. Intracyloplasmic sperm injection after total conventional in-vitro fertilization failure[J]. Saudi Med J,2005,26(3):411-415..
  5. 5. DEUGARTE C M, LI M, JORDAN B, et al. Rescue intracytoplasmic sperm injection and preimplantation genetic diagnosis in combination can result in pregnancy [J]. Fertil Steril,2006,86(1):200-202..
  6. 6. 曾勇,胡曉東,宋成,等.體外受精失敗后補(bǔ)行卵胞漿內(nèi)單精子注射的臨床價(jià)值探討[J].生殖與避孕,2006,26(1):32-34..
  7. 7. 李曉虹,于叢一,麥美琪,等.常規(guī)IVF不受精周期行補(bǔ)救卵母細(xì)胞單精子注射[J].中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版),2007,28(2):188-191..
  8. 8. FRIEDLER S, RAZIEL A, STRASSBURGER D, et al. Factors influencing the outcome of ICSI in patients with obstructive and non-obstructive azoospermia: a comparative study[J]. Hum Reprod,2002,17(12):3114-3121..
  9. 9. PEHLIVAN T, RUBIO C, RUIZ A, et al. Embryonic chromosomal abnormalities obtained after rescue intracytoplasmic sperm injection of 1-day-old unfertilized oocytes [J]. J Assist Reprod Genet,2004,21(2):55-57.〖ZK)〗.
  10. 10. NAGY Z P, RIENZI L F, UBALDI F M, et al. Effect of reduced oocyte aging on the outcome of rescue intracytoplasmic sperm injection [J]. Fertil Steril,2006,85(4):901-906..