不孕类型和不孕年限与常规体外受精结局的 相关性分析

Correlation of infertility type and infertility period with fertilization outcomes in routine in vitro fertilization

摘要:

目的 分析不孕类型和年限与常规体外受精（IVF）失败的相关性。方法 回顾性分析内蒙古医科 大学附属医院生殖医学中心2014 年3 月-2016 年10 月常规体外受精周期1 128 个。根据不孕类型分为原发 不孕组和继发不孕组，比较两组间不孕年限不同时间段的受精结局。结果 ①原发不孕组与继发不孕组在受 精率（69.36% vs 72.99%）、正常受精率（60.48% vs 62.00%）、卵裂率（94.96% vs 95.84%）、早期补救卵胞浆 内单精子注射（ICSI）率（8.96% vs 2.23%）比较，差异有统计学意义（χ2=27.175、4.085、4.494 和22.775， P =0.000、0.043、0.043 和0.000）；②两组不孕年限不同时间段比较，原发不孕组中不孕年限4 ～ 6 年及大于 6 年的受精失败率高于继发不孕组，差异有统计学意义（χ2=4.528 和4.580，P =0.034 和0.049）。结论 行常 规IVF 受精时，原发不孕及不孕年限长的患者存在受精失败的风险较高，建议行短时受精并及时进行早期补 救ICSI。

Abstract:

Objective To analyze the correlation of infertility type and infertility period with fertilization failure of conventional in vitro fertilization (IVF). Methods Totally 1,128 cycles of conventional IVF in the Reproductive Medical Center of the Affiliated Hospital of Inner Mongolia Medical University from March 2014 to October 2016 were retrospectively analyzed. According to the type of infertility, the patients were divided into primary infertility group (group A) and secondary infertility group (group B). The fertilization outcomes in different infertility periods were compared between the two groups. Results The fertilization rates in the group A and the group B were 69.36% and 72.99% respectively, the difference had statistical significance (χ2 = 27.175, P = 0.000). The normal fertilization rates in the group A and the group B (60.48% vs. 62.00%) had significant difference (χ2 = 4.085, P = 0.043). The cleavage rates (94.96% vs. 95.84%) and the R-ICSI rates (8.96% vs. 2.23%) in the group A and the group B also had statistical differences (χ2 = 4.494 and 22.775, P = 0.043 and 0.000 respectively). In comparison of the ICSI rate between the two groups, the patients with 4 or more years of infertility in the group A got a higher ICSI chance than those in the group B, the difference had statistical significance (χ2 = 4.528 and 4.580, P = 0.034 and 0.049). Conclusions There are many reasons for the failure of conventional IVF. The patients with primary infertility or long infertility period have a high risk of fertilization failure during IVF-ET, and to these patients short-term fertilization and timely ICSI are recommended.