Effect of different fertilization methods on pregnancy outcome of unexplained infertility patients
10.3760/cma.j.cn101441-20201124-00636
- VernacularTitle:不同授精方式对不明原因不孕患者妊娠结局的影响
- Author:
Yaojia ZHANG
1
;
Rui SHI
1
;
Yinfeng ZHANG
1
;
Yunshan ZHANG
1
Author Information
1. 天津市中心妇产科医院生殖中心 天津市人类发育与生殖调控重点实验室，天津 300052
- Publication Type:Journal Article
- Keywords:
Fertilization, in vitro;
Sperm injection, intracytoplasmic;
Infertility;
Pregnancy rate
- From:
Chinese Journal of Reproduction and Contraception
2022;42(7):682-687
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical pregnancy outcomes of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) fertilization in patients with unexplained infertility. Methods:A retrospective cohort study was conducted to analyze the clinical data of patients with unexplained infertility from July 2014 to July 2019 in the Assisted Reproductive Center of Tianjin Central Hospital of Gynecology Obstetrics. The patients were divided into IVF group ( n=299) and ICSI group ( n=234) according to the fertilization methods. The general information, fertilization condition, embryo development and pregnancy outcomes were compared between the two groups. Results:There were no statistically significant differences between ICSI group and IVF group in two pronuclei (2PN) fertilization rate, 2PN cleavage rate, and high-quality embryo rate (all P>0.05). Infertility type had a statistically difference between the two groups ( P<0.001). Stratified analysis was conducted according to the primary and secondary infertility. Among patients with primary infertility, 2PN cleavage rate in ICSI group [91.2% (1339/1468)] was higher than that in IVF group [87.8% (1646/1844), P=0.062]. There were no statistically significant differences in 2PN fertilization rate and high-quality embryo rate between the two groups (all P>0.05). The clinical pregnancy rate and the live birth rate in ICSI group [39.8% (74/186), 33.3% (62/186)] were higher than those in IVF group [37.8% (45/119), 31.1% (37/119)] without significant differences (all P>0.05). In the patients with secondary infertility, there were no statistically significant differences in 2PN fertilization rate, 2PN cleavage rate and high-quality embryo rate between the two groups (all P>0.05). The clinical pregnancy rate [20.8% (10/48)] and the live birth rate [18.8% (9/48)] of ICSI group were significantly lower than those of IVF group [49.4% (89/180), P<0.001; 40.0% (72/180), P=0.006]. After adjusting female age, infertility duration, body mass index, basal follicle-stimulating hormone and the number of oocyte retrieved, logistics regression showed that different fertilization methods had similar live birth rate ( OR=1.178, 95% CI=0.686-2.202) in primary infertility patients, and the live birth rate of ICSI group was significantly lower than that of IVF group ( OR=0.408, 95% CI=0.180-0.924) in secondary infertility patients. Conclusion:In patients with unexplained infertility, ICSI could not significantly improve fertilization rate, embryo quality and pregnancy outcome. Especially in patients with secondary infertility, IVF patients had significantly better pregnancy outcome than ICSI patients, and routine IVF fertilization should be preferred.
