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我们是否应该向所有无法解释不育的夫妇提供细胞内质精子注射:一项队列研究
Neeta Singh1, Neena Malhotra1, Reeta Mahey1
1Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India.
Journal of human reproductive sciences
|May 9, 2025
概括
内细胞质精子注射 (ICSI) 可以减少完全受精失败 (TFF) 在无法解释的不孕不育 (UI) 病例. 然而,诸如怀孕率等临床结果与传统体外受精 (IVF) 相当.
科学领域:
- 生殖医学 生殖医学
- 不孕症治疗 不孕症治疗
- 辅助生殖技术 辅助生殖技术
背景情况:
- 无法解释的不孕不育 (UI) 通常会导致更多地使用细胞内精子注射 (ICSI) 来预防完全受精失败 (TFF).
- 目前,有限的证据支持ICSI在UI病例中改善了临床结果.
研究的目的:
- 评估ICSI是否为患有不明原因不孕症的患者提供比常规体外受精 (IVF) 更好的结果.
- 为了在UI中比较ICSI和IVF周期之间的关键生育指标.
主要方法:
- 一个回顾性队列研究在三级中心进行.
- 进行首次刺激周期的UI患者 (21-38岁的女性) 被分为ICSI (A组) 和IVF (B组) 组.
- 排除标准包括救援-ICSI,供体周期和植入前遗传诊断;评估结果是受精率,TFF,胚胎质量,植入,流产和临床怀孕率.
主要成果:
- 总共有511名UI患者 (182名ICSI,310名试管婴儿) 进行了分析,具有类似的基线特征.
- 受精率是可以比较的 (67.18%的ICSI与66.93%的试管婴儿相比,P=0.92).
- 在ICSI组中,总受精失败 (TFF) 较低 (2.7%对5.8%,P=0.12),尽管在统计学上并不显著. 优质的第3天胚胎率相似 (P=0.93). 试管婴儿组的植入和临床怀孕率在数字上较高,但在统计学上并不显著 (P>0.05).
结论:
- 与IVF相比,ICSI显示了与IVF相比,在无法解释的不孕症中减少TFF的趋势.
- 临床结果,包括受精率,胚胎质量,植入和怀孕率,在这个UI队列中的ICSI和IVF组之间是可比的.
- 该研究表明,ICSI可能不会为无法解释的不孕症提供比常规试管婴儿更显著的临床优势,尽管TFF可能会减少.
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