本文選題：原發(fā)不孕　切入點(diǎn)：繼發(fā)不孕　出處：《中國(guó)婦產(chǎn)科臨床雜志》2017年01期

【摘要】：目的 探討常規(guī)IVF中原發(fā)、繼發(fā)不孕患者及早期補(bǔ)救ICSI對(duì)臨床結(jié)局的影響。方法 回顧性分析2012年1月至2014年12月行常規(guī)IVF及ICSI助孕治療患者資料1 733個(gè)周期,將1 097個(gè)IVF周期分為原發(fā)不孕組(571例)與繼發(fā)不孕組(526例),比較兩組患者不孕年限、年齡、基礎(chǔ)內(nèi)分泌、Gn總量、Gn天數(shù)、卵子受精率、胚胎種植率、補(bǔ)救率和妊娠率;針對(duì)不同的受精方式,還比較了IVF組、ICSI組、R-ICSI組的受精率、卵裂率、種植率、妊娠率及流產(chǎn)率。結(jié)果 原發(fā)不孕組與繼發(fā)不孕組比較,經(jīng)獨(dú)立樣本t檢驗(yàn),不孕年限差異有統(tǒng)計(jì)學(xué)意義(P0.05),原發(fā)不孕組妊娠率、胚胎種植率與繼發(fā)不孕組比較,經(jīng)卡方檢驗(yàn),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);原發(fā)不孕組卵子受精率(χ~2=23.641,P=0.000)、正常受精率(χ~2=4.042,P=0.045)、卵裂率(χ~2=4.015,P=0.045)、補(bǔ)救ICSI率(χ~2=5.044,P=0.025)與繼發(fā)不孕組比較,經(jīng)卡方檢驗(yàn),差異有統(tǒng)計(jì)學(xué)意義(P0.05);IVF組、ICSI組及R-ICSI組臨床結(jié)局差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 常規(guī)IVF受精中,原發(fā)不孕患者卵子受精率及正常受精率低,短時(shí)受精聯(lián)合R-ICSI可以有效地挽救IVF受精失敗的患者,能夠獲得較好的妊娠結(jié)局。
[Abstract]:Objective to investigate the effect of primary, secondary infertility and early rescue ICSI on clinical outcome in routine IVF. Methods from January 2012 to December 2014, 1 733 cycles of routine IVF and ICSI assisted pregnancy therapy were retrospectively analyzed. 1 097 IVF cycles were divided into primary infertility group (n = 571) and secondary infertility group (n = 526). The fertilization rate, cleavage rate, implantation rate, pregnancy rate and abortion rate in IVF group were compared with those in secondary infertility group. The pregnancy rate and embryo implantation rate in primary infertility group were compared with those in secondary infertility group, and were compared with those in secondary infertility group by chi-square test. There was no significant difference between primary infertility group and secondary infertility group (P 0.05). The fertilization rate of primary infertility group was 23.641%, the normal fertilization rate was 0.045%, the cleavage rate was 0.045% (蠂 ~ 24.015), and the recovery ICSI rate (蠂 ~ (25.044) P ~ (0.025)) was higher than that in secondary infertility group. There was no significant difference in clinical outcome between ICSI group and R-ICSI group. Conclusion in conventional IVF fertilization, egg fertilization rate and normal fertilization rate in primary infertile patients are low. Short-term fertilization combined with R-ICSI can effectively save patients with failed IVF fertilization and obtain better pregnancy outcomes.
【作者單位】： 內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院生殖醫(yī)學(xué)中心;

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