不明原因不育夫妇细胞质内精子注射成功率的预测因素

M. Hassan, R. Al-yasiry, A. M. K. AL-TUMA, Zainab Hayder Jaber Alkufaishi
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摘要

目的在生殖诊所的临床医生所面对的亚不孕症病例中,约有 10-15% 的病因不明。不孕不育专家对这些病例的最佳治疗方案的看法存在很大差异。本研究旨在评估原因不明的亚不孕夫妇接受卵胞浆内单精子显微注射(ICSI)的结果以及成功的预测因素:方法:共纳入 66 对不明原因的亚不孕夫妇。所有夫妇均接受了卵胞浆内单精子显微注射。他们分为怀孕和未怀孕两组。对他们进行回顾性随访,以评估卵胞浆内单精子显微注射治疗成功的预测因素,并将结果进行比较:化学妊娠率为 42.2%。妊娠女性明显更年轻,平均年龄(26.7±4.2)岁 vs 28.6±3.6岁,体重指数(27.6±4.9)比(30.2±4.9)更低,周期第2天LH水平(2.3±0.99)比(2.9±0.94)更低,子宫内膜(3.3±0.68)比(3.9±1.1)比未妊娠女性稍薄。两组女性对控制性卵巢刺激的反应无显著差异,取卵和成熟卵母细胞的平均总数相当,唯一的例外是未成熟卵母细胞的平均总数,妊娠女性为 0.85±1.1 对非妊娠女性为 30.2±4.9,但受精率、胚胎总数、卵裂率和胚胎质量无显著差异:结论:在一定范围内,细胞质内单精子注射有能力绕过不明原因不孕夫妇自然怀孕失败的障碍,因此应在女方年龄较大之前尽早考虑对这些夫妇进行细胞质内单精子注射。
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PREDICTORS OF INTRA CYTOPLASMIC SPERM INJECTION SUCCESS IN COUPLES WITH UNEXPLAINED SUB-FERTILITY
Objective: About 10-15% of sub-fertility cases facing the clinicians in the reproductive clinics remains unexplained. Opinions regarding the optimal treatment plan for them exhibit a wide differences among fertility specialists. This study aims to assess the outcome of ICSI and predictors success in couples with unexplained sub-fertility. Methods: Sixty six sub-fertile couples with unexplained infertility were included. ICSI was done for all. They divided into 2 groups pregnant and non-pregnant. They were followed up retrospectively to evaluate the predictors of ICSI treatment success and results were compared between them. Results: Chemical pregnancy was rate 42.2%. Pregnant females were significantly : younger with a mean age of 26.7±4.2 vs 28.6±3.6, lower BMI of 27.6± 4.9 vs 30.2± 4.9, lower cycle day 2 LH level 2.3 ±0.99 vs 2.9±0.94 and had a slightly thinner endometirum 3.3± 0.68 vs 3.9 ±1.1 than non-pregnant ones. Females of both groups exhibited no significant difference regarding the response to controlled ovarian stimulation, the mean total number of retrieved and mature oocytes were comparable, the only exception is the mean total number of immature oocytes which was significantly lower in the pregnant females 0.85± 1.1 vs 30.2± 4.9 in non-pregnant with no significant difference regarding fertilization rate, total number of embryos, cleavage rate and embryos’ quality. Conclusion: Intra cytoplasmic sperm injection has the ability, within certain limits, to bypass the obstacles of natural pregnancy failure in couples with unexplained sub-fertility and should be considered for those couples as early as possible before female partner get older.
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