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The Study on Embryo Quality, Clinical Outcomes and Birth Defects of Infertile Women by Intracytoplasmic Sperm Injection Treatment

Author: WangQingLing
Tutor: ChenShiLing
School: Southern Medical University,
Course: Obstetrics and Gynaecology
Keywords: Intracytoplasmic sperm injection Embryo transfer Fertilization Clinical pregnancy Childbirth Birth defects In vitro fertilization Intracytoplasmic sperm injection Insemination Infertility
CLC: R714.8
Type: Master's thesis
Year: 2009
Downloads: 159
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Abstract

The first part of the different parameters from different sources spermatozoa fertilization ICSI treatment, analysis research purposes retrospective analysis of clinical outcomes and birth defects due to non-male factor infertility and male factor line ICSI Intracytoplasmic sperm injection' dissertation">Intracytoplasmic sperm injection - embryo transfer (ICSI- ET) fertilization treatment, clinical outcomes, and offspring birth defects occur whether the differences, non-male factor shot sperm from the semen, normal or mildly abnormal semen parameters from the emission of semen, male factor sperm (severe oligospermia weak sperm), epididymis and testicles, explore different parameters from different sources sperm ICSI treatment on clinical outcomes and birth defects. Materials and Methods accepted Nanfang Hospital, Center for Reproductive Medicine in January 2003 - December 2008 ICSI-ET treatment of infertile patients with complete data and included in the statistical analysis of 980 cycles. According to the male semen parameters and sperm source, is divided into the following four groups: Group A: normal sperm density and motility: sperm concentration ≥ 20.0x10 ~ 6/ml sperm motility> 50%, or mildly abnormal: sperm density 10 ~ 20x10 ~ 6 and (or) activity rate <50%, a total of 168 cycles; B Group: severe oligoasthenozoospermia: semen density <5x10 ~ 6/ml and (or) activity rate <10%, a total of 610 cycles; Group C: epididymal sperm Groups: man obstructive azoospermia, a total of 156 cycles; D Group: testicular sperm group: divided into the following three cases: a man's semen is normal, but the date of oocyte retrieval of sperm retrieval difficulties, a total of 16 cycles ; b. the obstructive azoospermia epididymal sperm retrieval fails, a total of 46 cycles; c non-obstructive azoospermia, a total of 6 cycles. Woman the center of conventional ovulation induction and B ultrasound-guided oocyte retrieval, the man at the date of oocyte retrieval masturbation take sperm or epididymal puncture sperm retrieval (PESA) or testicular puncture sperm retrieval (TESA) sperm retrieval, select morphologically normal motile sperm for each of oocytes ICSI operations, training observed in patients with all the egg is fertilized, cleavage and the formation of the embryo, good quality embryos on the third day after ovulation or the fifth day of transplantation and continued follow-up of patients with pregnancy and childbirth, and to analyze the basic characteristics of the patients, fertilization and embryo as well as clinical outcomes. Results of four groups of normal fertilization rate, abnormal fertilization rate, the normal cleavage rate and good quality embryos was no significant difference (P> 0.05); C group of embryo implantation rate, clinical pregnancy rate was higher in group A and group B (P <0.05); A group (normal or mildly abnormal semen) birth defect rate of 2.3%, group B (the less serious asthenospermia) to 5.3%, 6.9% C group (sperm), no significant difference ( P> 0.05), group (D testicular sperm) no occurrence of birth defects. Conclusion 1. Different parameters, different sources of sperm line ICSI treatment can obtain satisfactory fertilization rate, cleavage rate, high-quality embryo rate and birth rate. Epididymal sperm obtained by embryo implantation rate and clinical pregnancy rate is higher, may be related to the age of this group of patients is lighter, more data about the number of oocytes. The probability of occurrence of 3.ICSI offspring birth defects with the reduction in the number of sperm, the decrease in vitality and maturity reduce the tendency to increase, still can not think the ICSI offspring incidence of birth defects with ICSI operating techniques directly related. The second part of the same oocyte retrieval cycle IVF combined with ICSI fertilization treatment, clinical outcomes and birth defects analysis of the purpose of analysis and comparison of primary and secondary infertility patients due to single or multiple infertility factors the same oocyte retrieval cycle implementation of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment fertilization, embryo quality, clinical outcomes and the differences of birth defects, analysis transplantation ICSI embryos and the clinical outcomes of conventional IVF embryos differences in birth defects, provide the basis for the to explore same period eggs using IVF and ICSI treatment indications and safety. Materials and Methods Analysis January 2003 - December 2008 Nanfang Hospital, Center for Reproductive Medicine for IVF combined with ICSI treatment of infertility patients, a total of 149 cases included in the study object. IVF indications and primary, secondary infertility classified into the following two groups: (1) primary infertility (except women with unexplained infertility) group, duration of infertility for ≥ 4 years, a total of 98 cases. Combined male semen parameters are undergoing IVF or ICSI threshold (1 × 10 6/ml ≤ sperm density <5x10 6 and (or) 1% ≤ sperm motility (ab) <10%) of 11 cases (11.2 %); combined cycle IVF fertilization rate is low (30% ≤ fertilization rate <50%) in 1 case (1.0%), and other pelvic tubal factor, endometriosis and PCOS patients with a total of 86 cases ( 87.8%). (2) secondary infertility group, a total of 51 cases. Of combined man critical semen of 21 cases (41.0%); combined cycles IVF fertilization rate is low in 1 case (2.0%); 29 cases combined with other indications unexplained infertility. Other reasons, such as repeated IVF treatment failure (number of cycles ≥ 3), unexplained secondary infertility, a total of 29 cases (56.9%). Woman superovulation and COH COH 2175 with the first part. Each patient using the eggs of the same cycle IVF with ICSI insemination, 1095 ova line conventional IVF fertilization, 1080 line an egg fertilized by ICSI. Analysis of each group of normal fertilization rate, abnormal fertilization rate, the normal cleavage rate, high-quality embryo rate, clinical pregnancy rate and birth defects. 1, on the same egg conventional IVF with ICSI treatment, ICSI part of the normal fertilization rate, high-quality embryo rate and the number of good quality embryos than conventional IVF, more refined abnormal fertilization rate is lower than IVF (P <0.05); 2, the original onset infertility group is not completely conventional IVF fertilization rate of 10.2%, 3.9% higher than the secondary infertility group, no significant difference (P> 0.05), primary and secondary infertility line ICSI were not there fertilization failure; primary infertility and secondary infertility patients ICSI fertilization is higher than conventional IVF, more refined abnormal fertilization rate is lower than IVF (P <0.05); primary and following the hair infertility fertilization and clinical outcomes between the two groups were combined male factor between the two groups and no significant difference (P> 0.05); 3, embryo implantation rates after ICSI sources embryo transfer, clinical pregnancy rate and delivery rate higher than conventional IVF embryo transfer group and IVF and ICSI hybrid embryo transfer group, the birth defect rate is less than conventional IVF embryos group and mixed shift embryonic group, no significant difference (P> 0.05), may be related to the small sample size. Conclusions. Conventional IVF with ICSI treatment on the same period in eggs, ICSI technology can improve normal fertilization rate, reduce the more refined abnormal fertilization rate, and improve the quality of embryos to increase the number of good quality embryos to improve the clinical pregnancy rate. 2 combined single or multiple male and female infertility factors in patients with primary infertility and secondary infertility IVF with ICSI treatment to obtain satisfactory clinical results, especially for patients with primary infertility, can be avoided the same time there are other clear cause selection methods of fertilization and treatment outcomes for patients with primary infertility compared with patients with secondary infertility, IVF fertilization failure are more likely to trend. 3.ICSI source of fertilized embryos clinical outcomes better than IVF embryos trend, and no increase in birth defects compared with conventional IVF embryos trend, but the sample size, the need to increase the sample size further study.

The Study on Embryo Quality, Clinical Outcomes and Birth Defects of Infertile Women by Intracytoplasmic Sperm Injection Treatment

Abstract

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