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目的:为体外成熟卵母细胞(IVM)及重度畸形精子症选择有效、安全、经济的受精方式。方法:一组为拟接受常规体外受精(IVF)改为IVM的患者,另一组为重度畸形精子症患者(改良巴氏染色正常形态精子<5%,密度>20×106/mL,a+b级精子≥50%)。如患者获未成熟卵母细胞数≥15,选择其1/3卵母细胞行常规IVF方式受精,余2/3卵母细胞行单精子卵胞浆内注射方式受精。比较同一患者同一周期不同受精方式的受精率、卵裂率、优质胚胎率。结果:两种受精方式的受精率、卵裂率、优质胚胎率均无明显差异,两组中共有4例临床妊娠。结论:(1)为防止超排卵发生的卵巢过度刺激而由常规IVF改为IVM时,若男方精液质量和形态均正常,可以选择常规IVF方式受精。(2)重度畸形精子症者若精液质量正常,亦可选择常规IVF方式受精。
Objective: To choose an effective, safe and economical way of fertilization for IVM and severe deformity sperm disease in vitro. Methods: One group was patients scheduled to undergo conventional in vitro fertilization (IVF) to IVM, and the other group was patients with severe deformity sperm (modified sutures normal spermatozoa <5%, density> 20 × 106 / mL, b grade sperm ≥ 50%). If the number of patients with immature oocytes ≥ 15, choose one-third of the oocytes normal IVF fertilization, the remaining 2/3 oocyte sperm intracytoplasmic sperm injection. The fertilization rate, cleavage rate and quality embryo rate of different fertilization methods in the same cycle were compared. Results: There was no significant difference in fertilization rate, cleavage rate and high quality embryos between the two fertilization modes. There were 4 clinical pregnancies in both groups. CONCLUSION: (1) In order to prevent over-stimulation of ovarian hyperstimulation and change from conventional IVF to IVM, if male sperm quality and morphology are normal, we can choose routine IVF fertilization. (2) Severe deformity sperm disorder If the sperm quality is normal, you can choose the routine IVF fertilization.