Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post-insemination in conventional IVF
Rescue ICSI of oocytes that failed to extrude the second polar body 6 h post-insemination in conventional IVF
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DOI：
10.1093/humrep/deg325
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发表时间：
2003-10-01
影响因子：
6.1
通讯作者：
Kattera, S
中科院分区：
文献类型：
--
作者：
Chen, C;Kattera, S
背景：传统 IVF 后 24 小时仍未受精的 ICSI 卵母细胞“拯救”的尝试通常会导致不良结果。本研究的目的是比较一组患者在初次授精后 6 小时进行救援 ICSI 的结果与另一组患者在初次授精后 22 小时进行救援 ICSI 的结果。方法：在这项回顾性研究中，25 个患者 IVF 周期在初次授精后 6 小时提供用于挽救 ICSI 的卵母细胞，20 个周期在初次授精后 22 小时提供用于挽救 ICSI 的卵母细胞。受精率和卵裂率、胚胎质量、植入和救援 ICSI 后的妊娠率是主要的结局指标。结果：6 小时救援 ICSI 的受精率为 70.3%，而 22 小时救援 ICSI 的受精率为 48.5%（P < 0.0001）。从 6 小时救援 ICSI 中，12 例临床妊娠 (48.0%) 产生了 3 对双胞胎、8 例单胎和 1 例流产。从 22 小时救援 ICSI 来看，有 1 例 (5.0%) 单胎妊娠并产下健康婴儿。同样，6 小时救援 ICSI 的着床率为 20.2%，而 22 小时救援 ICSI 的着床率为 1.72%（P < 0.02）。结论：与卵母细胞老化后 22 小时后挽救 ICSI 相比，授精后 6 小时（HCG 后 46 小时）后挽救 ICSI 具有更好的受精率、妊娠率和着床率。
BACKGROUND: Attempts to 'rescue' by ICSI oocytes that remained unfertilized 24 h after conventional IVF have generally resulted in poor outcomes. The aim of the present study was to compare the outcome of rescue ICSI performed on one group of patients 6 h after initial insemination with those of another group where rescue ICSI was performed 22 h after initial insemination. METHODS: Twenty-five patient IVF cycles provided the oocytes for rescue ICSI 6 h after initial insemination, and 20 cycles provided the oocytes for rescue ICSI 22 h after initial insemination in this retrospective study. Fertilization and cleavage rates, embryo quality, implantation, and pregnancy rates after rescue ICSI were the main outcome measures. RESULTS: A fertilization rate of 70.3% was achieved with 6 h rescue ICSI compared with 48.5% with 22 h rescue ICSI (P < 0.0001). From 6 h rescue ICSI, 12 clinical pregnancies (48.0%) resulted in three sets of twins, eight singletons and one abortion. From 22 h rescue ICSI there was one (5.0%) singleton pregnancy and delivery of a healthy baby. Likewise, the implantation rate was 20.2% from 6 h rescue ICSI compared with 1.72% from 22 h rescue ICSI (P < 0.02). CONCLUSIONS: Rescue ICSI after 6 h post-insemination (46 h post-HCG) gave better fertilization, pregnancy and implantation rates compared with rescue ICSI after 22 h when oocytes have become aged.