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目的探讨精子形态与受精率、优胚率及妊娠率之间的关系。方法回顾性分析2009年11月—2012年3月接受体外受精(in vitro fertilization,IVF)-胚胎移植(embryo transfer,ET)助孕患者及同时期全部接受精子形态学检验患者的资料,比较了IVF过程中受精率≤50%患者精子正常形态率与全部受检者精子正常形态率;精子形态≤14%且受精失败患者行补救性(rescue,RES)-单精子胞浆内显微注射(intracytoplasmic sperm injection,ICSI)后受精率、优质胚胎率、临床妊娠率与常规ICSI各指标间进行比较。结果 IVF过程中受精率≤50%患者共有66例,精子正常形态率为(12.64±6.12)%;同时期全部精子形态检验共2 800例,正常形态率为(14.43±7.23)%;两组比较差异有统计学意义(P<0.05);精子正常形态≤14%且不受精行RES-ICSI患者共14例,其受精率、优质胚胎率、临床妊娠率与常规ICSI各指标分别为(85.0±6.5)%VS(86.0±7.2)%、(57.0±4.5)%VS(55±3.5)%、65%VS51%。结论受精率与精子形态有关,精子正常形态率低可导致低受精,精子正常形态率低者可应用ICSI进行受精。
Objective To explore the relationship between sperm morphology and fertilization rate, excellent embryo rate and pregnancy rate. Methods The data of patients undergoing in vitro fertilization (IVF) -embryo transfer (ET) pregnancy and all the patients undergoing sperm morphometry at the same period from November 2009 to March 2012 were retrospectively analyzed. Sperm morphology ≤14% and sperm morphology ≤14% and rescue fertilization failure rescue (RES) - sperm intracytoplasmic microinjection (IVF) ≤50% of normal sperm morphology and sperm normal morphology rate of all subjects; intracytoplasmic sperm injection (ICSI) fertilization rate, high quality embryo rate, clinical pregnancy rate and routine ICSI were compared between the indicators. Results There were 66 cases of fertilization rate ≤50% and the normal sperm morphology rate was (12.64 ± 6.12)%. In the same period, 2 800 cases of sperm morphology test and 14.43 ± 7.23% of normal morphology were found in both groups (P <0.05). The normal morphology of sperm was 14% or less and 14 patients were not enrolled in RES-ICSI. The fertilization rate, high-quality embryo rate, clinical pregnancy rate and routine ICSI indexes were 85.0 ± 6.5% VS (86.0 ± 7.2)%, (57.0 ± 4.5)% VS (55 ± 3.5)%, 65% VS51%. Conclusion The fertilization rate is related to the morphology of spermatozoa. Low normal sperm morphology can lead to low fertilization. ICSI can be fertilized by low sperm normal morphology.