Comparative analysis of conventional in vitro fertilization and intracytoplasmic sperm injection in patients with polycystic ovarian syndrome, tubal factor infertility, and unexplained infertility whose partners exhibit normal semen parameters: a retrospective study of sibling oocytes.
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Abstract
Objective: This study compared the outcomes of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) in patients with polycystic ovarian syndrome (PCOS), tubal factor (TF) infertility, and unexplained infertility whose partners had normal semen parameters.
Methods: This retrospective study included 360 couples diagnosed with infertility involving PCOS (n=157), unexplained infertility (n=140), and TF infertility (n=63). Sibling oocytes were randomly assigned to undergo ICSI or conventional IVF insemination. The fertilization rate and embryo morphology were evaluated as outcomes.
Results: Retrieved cumulus-oocyte complexes from patients with PCOS (2,974), unexplained infertility (1,843), and TF infertility (844) were split and inseminated by conventional IVF and ICSI respectively. In comparison to the ICSI method, the conventional IVF approach was linked to a significantly higher fertilization rate in groups with PCOS (68.81% vs. 77.49%), unexplained infertility (67.62% vs. 78.84%), and TF issues (69.23% vs. 78.63%) (p<0.05). The proportion of embryos with grade A produced by the conventional IVF method was significantly higher than that produced using the ICSI method in the PCOS and unexplained infertility groups (p<0.05). Additionally, the percentage of grade B embryos produced with the ICSI method was significantly higher than that produced with the conventional IVF method in PCOS patients (p=0.002).
Conclusion: Our results indicated that the conventional IVF method was associated with higher zygote production and a higher proportion of grade A embryos when all infertile groups were evaluated together. Thus, ICSI is not suggested for patients with these causes of infertility if their partner has normal semen parameters.
研究目的本研究比较了伴侣精液参数正常的多囊卵巢综合征（PCOS）、输卵管因素（TF）不孕症和不明原因不孕症患者的常规体外受精（IVF）和卵胞浆内单精子显微注射（ICSI）的结果：这项回顾性研究包括 360 对被诊断为多囊卵巢综合征（PCOS）（157 对）、不明原因不孕（140 对）和输卵管因素不孕（63 对）的不孕夫妇。同胞卵母细胞被随机分配接受卵胞浆内单精子显微注射（ICSI）或传统试管婴儿授精。结果对受精率和胚胎形态进行了评估：从多囊卵巢综合征（2974 例）、不明原因不孕症（1843 例）和 TF 不孕症（844 例）患者体内提取的精母细胞复合体进行了分离，并分别采用常规体外受精和卵胞浆内单精子显微注射进行授精。与卵胞浆内单精子显微注射法相比，常规体外受精法在多囊卵巢综合征（68.81% vs. 77.49%）、不明原因不孕（67.62% vs. 78.84%）和TF问题（69.23% vs. 78.63%）群体中的受精率明显更高（P结论：我们的研究结果表明，在对所有不孕症群体进行综合评估时，传统试管婴儿方法与较高的合子产量和较高的 A 级胚胎比例相关。因此，如果患者的配偶精液参数正常，则不建议对这些原因导致的不孕症患者采用卵胞浆内单精子显微注射法。
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