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目的:回顾性分析100%畸形精子症患者的临床资料,比较常规IVF受精和ICSI受精的临床结局,旨在探讨ICSI是否改善100%畸形精子症患者的临床结局。方法:选择本院生殖中心152对IVF-ET治疗夫妇,其中常规IVF新鲜移植周期75例,ICSI新鲜移植周期77例。比较两组间的正常受精率、优胚率、可用胚胎率、种植率、临床妊娠率及流产率等指标,并对正常形态精子百分率为0%(n=75)与正常形态精子百分率为1%~4%(n=808)行常规IVF的临床结局进行比较。结果:100%畸形精子症IVF组的可用胚胎率显著低于ICSI组(78.91%vs 84.92%,P<0.05),正常受精率(60.26%vs 57.87%,P>0.05)和种植率(48.00%vs 39.55%,P>0.05)稍高于ICSI组,但差异无统计学意义。两组间的女方年龄、促性腺激素注射天数、促性腺激素注射总量、体质指数、不育年限、子宫内膜厚度、基础卵泡雌激素值和基础血清雌激素值均无显著性差异。结论:ICSI技术不能改善男方100%畸形精子症患者的临床结局。
OBJECTIVE: To retrospectively analyze the clinical data of 100% patients with teratogenic spermatozoa and to compare the clinical outcomes of routine IVF fertilization and ICSI fertilization to explore whether ICSI can improve the clinical outcome of 100% patients with teratogenic spermatozoa. Methods: A total of 152 IVF-ET-treated couples were selected as reproductive centers in our hospital. Among them, 75 cases were routine fresh IVF transplantation cycles and 77 cases were fresh ICSI cycles. The normal fertilization rate, excellent embryo rate, available embryo rate, implantation rate, clinical pregnancy rate and abortion rate were compared between two groups. The percentage of normal spermatozoa was 0% (n = 75) and normal morphology was 1 % ~ 4% (n = 808) clinical outcomes of routine IVF were compared. Results: The available embryo rate in IVF group was significantly lower than that in ICSI group (78.91% vs 84.92%, P <0.05), normal fertilization rate (60.26% vs 57.87%, P> 0.05) and implantation rate vs 39.55%, P> 0.05) slightly higher than ICSI group, but the difference was not statistically significant. There was no significant difference in age, gonadotrophin injection days, total gonadotrophin injections, body mass index, length of infertility, endometrial thickness, basal follicle-derived estrogen value, and basal serum estrogen value between the two groups. CONCLUSIONS: ICSI does not improve the clinical outcomes in men with 100% deformity sperm disease.