论文部分内容阅读
目的研究体外受精(IVF)与卵胞浆内单精子注射(ICSI)对100%畸形精子症病患妊娠情况的影响。方法选择2012年8月至2014年10月在我院生殖中心接受治疗的100%畸形精子症病患148对,其中79对病患选择进行IVF治疗,另外69对病患选择ICSI治疗。对比两组妊娠结果与胚胎结果,并且根据妊娠结局分为妊娠组20例和未妊娠组128例。并采用logistics回归分析影响100%畸形精子症病患妊娠的危险因素。结果 IVF组优质胚胎率、正常受精率显著低于ICSI组,而早孕流产率显著高于ICSI组,差异均存在统计学意义(均P<0.05)。但两组间可用胚胎率、胚胎植入率以及临床妊娠率对比无差异(P>0.05)。根据Logistic回归性分析筛选出3个影响因素,即:优质胚胎、可用胚胎以及子宫内膜厚度。结论采用ICSI对100%畸形精子症病患妊娠率提高效果不明显,但是能有效降低早孕流产率。其中子宫内膜厚度、胚胎质量是影响妊娠结局的主要因素,在临床上具有较高的指导价值。
Objective To investigate the effect of IVF and intracytoplasmic sperm injection (ICSI) on pregnancy in 100% patients with teratospermia. Methods A total of 148 pairs of 100% malformed spermatozoa were selected from August 2012 to October 2014 in our reproductive center. Among them, 79 patients were selected for IVF treatment and 69 patients were selected for ICSI treatment. The results of pregnancy and embryo were compared between the two groups and divided into pregnancy group (20 cases) and non-pregnancy group (128 cases). Logistic regression analysis was used to analyze the risk factors for pregnancy in 100% patients with teratospermia. Results The rate of high quality embryo and normal fertilization in IVF group was significantly lower than that in ICSI group, while the rate of abortion in early pregnancy was significantly higher than that in ICSI group (all P <0.05). However, there was no difference in available embryo rate, embryo implantation rate and clinical pregnancy rate between the two groups (P> 0.05). According to Logistic regression analysis, three influencing factors were screened: high quality embryos, available embryos and endometrial thickness. Conclusions ICSI can improve the pregnancy rate in 100% patients with abnormal spermatogenesis without obvious effect, but it can effectively reduce the miscarriage rate in early pregnancy. The thickness of endometrium and the quality of embryo are the main factors affecting the outcome of pregnancy, which has a high guiding value in clinic.