目的:探讨卵子透明带透亮致密患者行常规体外受精(IVF)或卵胞质内单精子显微注射(ICSI)后受精、胚胎发育情况及临床结局。方法:回顾性分析体外受精过程中卵子出现透明带透亮致密的43个周期,其中IVF周期27例,ICSI周期16例,比较受精率与正常受精比例、胚胎质量、临床妊娠结局。结果:27例IVF周期均未受精,行早期补救ICSI,其中23例完全不受精。补救后IVF总体受精率达64.83%,正常受精率59.32%;16例ICSI周期均受精,受精率和正常受精率分别为85.11%和79.01%,均显著高于IVF组(P<0.05)。IVF组和ICSI组卵裂率分别为97.96%、95.65%,优质胚胎率分别为52.67%、43.75%,组间差异无统计学意义(P>0.05)。IVF组妊娠率为37.04%,种植率为33.33%;ICSI组妊娠率为31.25%,种植率为25.00%,组间临床结局相近,无统计学差异(P>0.05)。结论:透明带透亮致密患者的自然受精能力下降,需要采用ICSI方式授精。常规IVF受精失败后采用早期补救ICSI或直接行ICSI能明显改善透明带透亮致密患者的受精结局,但不能改善妊娠结局。 Objective: To investigate the fertilization, embryo development and clinical outcome of ovarian zona pellucida translucent patients after routine in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Methods: The 43 cycles of translucent and zona pellucida of ova during in vitro fertilization were retrospectively analyzed. There were 27 IVF cycles and 16 ICSI cycles. The fertilization rate, normal fertilization rate, embryo quality and clinical pregnancy outcome were compared. Results: All 27 cases of IVF were not fertilized, and ICSI was performed in early stage, of which 23 cases were completely unfertilized. The total fertilization rate of IVF was 64.83% and the normal fertilization rate was 59.32% after remediation. 16 cycles of ICSI were fertilized, the fertilization rate and normal fertilization rate were 85.11% and 79.01% respectively, which were significantly higher than IVF group (P <0.05). The cleavage rates of IVF group and ICSI group were 97.96% and 95.65%, respectively, and the high-quality embryos rates were 52.67% and 43.75% respectively. There was no significant difference between the two groups (P> 0.05). The pregnancy rate in IVF group was 37.04% and the implantation rate was 33.33%. The pregnancy rate in ICSI group was 31.25% and the implantation rate was 25.00%. There was no significant difference between the two groups in clinical outcome (P> 0.05). CONCLUSIONS: Patients with clear and dense zona pellucida degrade their ability to naturally fertilize, requiring ICSI insemination. The failure of routine IVF fertilization after the use of early recovery ICSI or direct ICSI can significantly improve the zona pellucida translucent dense patients with fertilization outcomes, but can not improve pregnancy outcomes.