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目的:分析不同来源和质量精子对卵胞浆内单精子注射术(ICSI)治疗结局的影响。方法:2008年7月～2011年12月在苏州医院生殖中心进行ICSI和部分卵子卵胞浆内单精子注射(Half ICSI)治疗,女方采用常规促排卵方案(长方案、短方案和拮抗剂方案),年龄≤35岁,共361个周期。根据精子来源与质量分为4组:A组(PESA取精,48例),B组(重度少弱精组,处理后前向运动精子总数为<1×106/ml,95例),C组(轻度少弱精组,处理后前向运动精子总数1～10×106/ml之间,98例),D组(正常精子组,处理后前向运动精子总数>10×106/ml,120例)。比较4组间正常受精率、优胚率、临床妊娠率和种植率的差异。结果:除C组与D组外,其余各组间正常受精率间均有显著差异,差异有统计学意义(P<0.05);而优胚率、临床妊娠率和种植率在这4组间无显著差异,差异无统计学意义(P>0.05)。结论:不同来源和质量的精子对ICSI的正常受精率存在影响,但不影响ICSI的优胚率、临床妊娠率和种植率。
Objective: To analyze the effect of sperm of different origins and qualities on intracytoplasmic sperm injection (ICSI). METHODS: From July 2008 to December 2011, ICSI and partial ICSI were performed in the Reproductive Center of Suzhou Hospital. The women adopted the conventional ovulation induction protocol (long-term, short-term and antagonist programs ), ≤ 35 years of age, a total of 361 cycles. According to the source and quality of sperm, the rats were divided into 4 groups: group A (PESA, 48 cases), group B (group with severe oligoastheniae, total number of treated forward motile sperm <1 × 106 / ml, 95 cases) (Mild oligoasthenospermia group, the total number of motile spermatozoa after treatment was 1 ~ 10 × 106 / ml, 98 cases), D group (normal sperm group, the total number of forward motile sperm after treatment> 10 × 106 / ml , 120 cases). The differences of normal fertilization rate, excellent embryo rate, clinical pregnancy rate and implantation rate between the four groups were compared. Results: Except for group C and group D, the normal fertilization rates of other groups were significantly different (P <0.05), while the rates of excellent embryo pregnancy, clinical pregnancy rate and implantation rate were significantly higher in these four groups No significant difference, the difference was not statistically significant (P> 0.05). CONCLUSIONS: Sperm of different origins and masses have an effect on the normal fertilization rate of ICSI but do not affect the excellent embryo rate, clinical pregnancy rate and implantation rate of ICSI.