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目的:对原发不孕≥5年,男方精液正常或原发不孕≥4年,伴男方精液异常但达不到卵胞浆内单精子显微注射(ICSI)指征的患者,探讨是否存在IVF联合ICSI治疗的必要性与可行性。方法:2006年8月～2009年3月接受体外助孕的夫妇中,选取符合指征者,采用常规超排卵方案,同一周期取得的卵子随机分半,分别进行常规体外受精(IVF)与ICSI治疗。卵裂球≥4个且碎片≤30%的胚胎为可用胚胎。结果:共78个周期采用IVF联合ICSI治疗,其中常规IVF受精失败或低下(LFR)17个周期(21.8%);同期常规IVF治疗204周期,其中LFR8个周期(3.9%),两者LFR周期发生率有显著差异(P<0.005)。研究组共获959枚卵子,其中行常规IVF 470枚,受精率56.8%,行ICSI 408枚,受精率72.3%。两者受精率有显著差异。78个周期临床妊娠率为37.2%。结论:存在对原发不孕≥5年,男方精液正常或原发不孕≥4年,伴男方精液异常但达不到ICSI标准者行IVF联合ICSI治疗的必要性,可明显减少不受精情况的出现。对常规IVF与ICSI均受精的周期,可优先选择移植常规IVF胚胎,以减少子代遗传和先天缺陷的风险。
OBJECTIVE: To investigate whether or not primary infertility is more than 5 years old, with normal or primary male infertility 4 years or older, with men’s sperm abnormalities but less than intracytoplasmic sperm injection (ICSI) Necessity and feasibility of IVF combined with ICSI treatment. METHODS: Among the couples receiving IVF from August 2006 to March 2009, those who were eligible for IVF and ICSI were enrolled in this study. All ovums from the same cycle were randomly divided into half and normal in vitro fertilization (IVF) and ICSI treatment. Embryos with> 4 blastomeres and <30% debris are available embryos. Results: Seventeen cycles (21.8%) of routine IVF fertilization failure or low-grade (LFR) were performed in 78 cycles of IVF combined with ICSI. In the same period of conventional IVF treatment, 204 cycles of LFR8 cycles (3.9%), LFR cycle The incidence was significantly different (P <0.005). The study group received a total of 959 eggs, of which routine 470 IVF, fertilization rate of 56.8%, line ICSI 408, fertilization rate of 72.3%. There was a significant difference in fertilization rate between the two. 78 cycles of clinical pregnancy rate was 37.2%. CONCLUSIONS: There is a need for IVF combined with ICSI in patients with primary infertility ≥ 5 years, normal men or women with primary infertility ≥ 4 years, men with abnormal sperm but not up to ICSI criteria, The emergence of. For cycles routinely fertilized with both IVF and ICSI, conventional IVF embryos can be preferentially transplanted to reduce the risk of inheritance and birth defects in offspring.