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目的探讨不明原因不孕患者首次IVF治疗影响其受精率的因素。方法将44个首次行IVF方案的不明原因不孕患者的,根据受精率高低划分为受精率高组(A组28例,受精率>50%)和受精率低组(B组16例,受精率≤50%),比较2组之间年龄、不孕年限、促排卵方案、成熟卵母细胞数、优质胚胎数、妊娠率及种植率有无差异。结果 44例患者在年龄、基础FSH、启动Gn数、用药时间、总Gn用量、获得卵细胞均无明显统计学差异,但A组不孕时间短于B组,且获得成熟卵母细胞的比率较B组高,获得的优质胚胎率也显著高于B组,有统计学差异(P=0.002,P<0.05);A组临床妊娠率为32%,高于B组的14.28%。结论不明原因不孕患者行首次IVF治疗时,应综合分析年龄、不孕时间及获卵数来判断受精方式,不要盲目扩大ICSI指征。
Objective To investigate the factors that affect the fertilization rate of the first IVF treatment in patients with unexplained infertility. Methods Forty-four infertile patients with unexplained infertility who underwent IVF regimen for the first time were divided into two groups: high fertilization rate (28 in group A, fertilization rate> 50%) and low fertilization rate (16 in group B, fertilization Rate≤50%). The differences of age, duration of infertility, ovulation induction, number of mature oocytes, number of high quality embryos, pregnancy rate and implantation rate were compared between the two groups. Results 44 patients had no significant difference in age, basal FSH, Gn number, medication duration, total Gn dosage, but the ovulation rate in group A was shorter than that in group B, and the ratio of mature oocytes The high-quality embryos obtained in group B were also significantly higher than those in group B (P = 0.002, P <0.05). The clinical pregnancy rate in group A was 32%, which was higher than that in group B (14.28%). Conclusion In the first IVF treatment of patients with unexplained infertility, the age, time of infertility and the number of oocytes retrieved should be used to determine the mode of fertilization. Do not blindly expand the indications of ICSI.