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目的:探讨卵胞浆内单精子注射(ICSI)对非男性因素不孕IVF失败患者治疗结局的影响。方法:回顾性分析由于第一周期常规IVF治疗中卵子完全不受精或受精率≤25%,行补救性ICSI的10个周期(补救性ICSI组),以及因前次受精失败而在随后的治疗周期中采取ICSI方法受精的19个周期(后续性ICSI组)的ICSI治疗结局,并以因男方少弱精子症进行第1次ICSI治疗的133个周期为对照组。结果:后续性ICSI组受精率、植入率、妊娠率和分娩率均高于补救性ICSI组,但差异均无统计学意义(P>0.05)。后续性ICSI组优胚率显著高于补救性ICSI组(P<0.05);补救性ICSI组受精率(48.9%)、优质胚胎率(29.2%)、植入率(0%)、妊娠率(0%)、分娩率(0%)均显著低于对照组(分别为72.1%、46.6%、21.2%、45.1%、39.1%);后续性ICSI组受精率、植入率、妊娠率、分娩率分别为55.4%、8.8%、21.1%、15.8%,均低于对照组(P<0.05或P<0.01)。优质胚胎率后续性ICSI组(44.2%)低于对照组,但无统计学差异。结论:对于非男性因素不孕IVF失败患者,ICSI能避免受精失败,但是受精率以及妊娠结局受到卵母细胞隐匿性异常的影响。
Objective: To investigate the effect of intracytoplasmic sperm injection (ICSI) on the outcome of non-male infertility patients with IVF failure. METHODS: A retrospective analysis of 10 cycles of salvage ICSI (salvage ICSI group) due to complete fertilization or fertilization of less than 25% of fertilized eggs during routine IVF in the first cycle, and subsequent follow-up treatment due to failed previous fertilization ICSI treatment of 19 cycles (follow-up ICSI group) fertilized by ICSI method was performed in the cycle, and 133 cycles of the first ICSI treatment for male oligozoospermia were used as the control group. Results: The fertilization rate, implantation rate, pregnancy rate and delivery rate in follow-up ICSI group were higher than those in ICSI group, but the difference was not statistically significant (P> 0.05). The excellent embryo rate in ICSI group was significantly higher than that in ICSI group (48.9%), high quality embryo rate (29.2%), implantation rate (0%) and pregnancy rate 0%) were significantly lower than those in the control group (72.1%, 46.6%, 21.2%, 45.1%, 39.1%, respectively). The fertilization rate, implantation rate, pregnancy rate, delivery rate The rates were 55.4%, 8.8%, 21.1% and 15.8%, respectively, lower than that of the control group (P <0.05 or P <0.01). Good quality embryo rate ICSI group follow-up (44.2%) lower than the control group, but no significant difference. CONCLUSIONS: ICSI can prevent fertilization failure in patients with non-men with IVF failure but infertility and pregnancy outcomes are implicated in oocyte occult abnormalities.