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目的:比较行half-ICSI治疗中IVF受精率的差异对half-ICSI治疗结局的影响。方法:回顾性分析配偶精液分析处于临界状态,无法排除受精失败可能的患者,以及前次IVF受精失败的患者,采用half-ICSI治疗,并根据IVF部分的受精情况进行分组,其中IVF受精失败(定义为IVF受精率≤25%)的half-ICSI组为研究组,包括IVF受精率为0的完全受精失败half-ICSI组24个周期及IVF受精率低下的half-ICSI组19个周期;而IVF正常受精(定义为IVF受精率≥65%)的half-ICSI组19个周期作为对照组。结果:IVF完全受精失败的half-ICSI组中ICSI的受精率、卵裂率、优质胚胎率、植入率、妊娠率、分娩率、流产率分别为68.94%、95.50%、53.77%、19.23%、33.33%、33.33%、0%,IVF受精率低下的half-ICSI组ICSI的受精率、卵裂率、优质胚胎率、植入率、妊娠率、分娩率、流产率分别为71.43%、94.4%、52.54%、18.75%、36.84%、31.58%、14.29%,与对照组即IVF正常受精的half-ICSI组(分别为81.34%、97.25%、55.66%、21.74%、36.84%、36.84%、0%)相比,除受精率研究组与对照组有显著差异外(P<0.05),其余各率差异均无差异(P>0.05)。3组精液分析也无统计学差异。结论:half-ICSI中IVF受精失败将影响ICSI的受精率,但是对胚胎发育及妊娠结局并无显著影响。
OBJECTIVE: To compare the effect of IVF fertilization on the outcome of half-ICSI in half-ICSI. Methods: A retrospective analysis of the spouse semen analysis at a critical condition, unable to rule out the possibility of fertilization failure patients, and the last IVF fertilization failure patients treated with half-ICSI, and IVF part of the fertilization group, including IVF fertilization failure Defined as IVF fertilization rate ≤ 25%) of the half-ICSI group as the study group, including IVF fertilization rate of 0 full fertilization failure half-ICSI group 24 cycles and IVF fertilization rate of low-half-ICSI group 19 cycles; 19 cycles of half-ICSI group with normal fertilization of IVF (defined as IVF fertilization≥65%) served as control group. Results: The fertilization rate, cleavage rate, high quality embryo rate, implantation rate, pregnancy rate, delivery rate and abortion rate of ICSI in the half-ICSI group failed to complete IVF fertilization were 68.94%, 95.50%, 53.77%, 19.23% , 33.33%, 33.33%, 0%. The fertilization rate, cleavage rate, high quality embryo rate, implantation rate, pregnancy rate, delivery rate and abortion rate of ICSI in half-ICSI group with low IVF fertilization rate were 71.43%, 94.4 (81.34%, 97.25%, 55.66%, 21.74%, 36.84%, 36.84%, respectively) in the half-ICSI group, (P <0.05). There was no significant difference between the fertilization rate and the control group (P> 0.05). There was no statistical difference in semen analysis among the three groups. Conclusion: The failure of IVF fertilization in half-ICSI will affect ICSI fertilization rate, but it has no significant effect on embryonic development and pregnancy outcome.