Objectives: To investigate the possible factors relevant to fertilization failure in in vitro fertilization-embryo transfer (IVF-ET).
Methods: The medical records of 4 205 infertile patients undergoing IVF-ET treatment at the Reproductive Medicine Center, Xiangya Hospital, Central South University from January 2016 to December 2017 were collected. The patients were divided into a complete fertilization failure group, a low fertilization rate group, and a control group based on fertilization rate. We examined the associations among the 3 groups in terms of female age, duration of infertility, duration of stimulation, gonadotropin (Gn) dosage, follicle-stimulating hormone (FSH) dosage, and total number of retrieved oocytes. According to theincidence factors, the patients were divided into a single female factor group, a single male factor group and a unisex factor group, and the correlation analysis of incidence factor among the 3 groups was performed. The patients were divided into a primary infertility and a secondary infertility in accordance with the type of infertility. We analyzed the correlation of infertility type among the three groups. Risk factors for complete fertilization failure and low fertilization rate in IVF-ET were obtained by stepwise multiple linear regression analysis.
Results: Primary infertility, long infertility duration, total number of retrieved oocytes, and unisex factor were associated with completefertilization failure and low fertilization rate in IVF-ET (P<0.05), but female age, duration of stimulation, FSH dosage as well as Gn dosage were not correlated with complete fertilization failure and low fertilization rate in IVF-ET (P>0.05). Stepwise multiple linear regression analysis showed that the incidence factor, type of infertility, and infertility duration were independent influential factors for complete fertilization failure and low fertilization rate.
Conclusions: Complete fertilization failure and low fertilization rate in IVF-ET are related to duration of infertility, total number of retrieved oocytes, cause of onset, and type of infertility, but they are not relevant to female age, duration of stimulation, and Gn and FSH dosage.
目的: 探讨体外受精-胚胎移植(in vitro fertilization-embryo transfer，IVF-ET)中受精失败的相关因素。方法: 收集2016年1月至2017 年12月在中南大学湘雅医院生殖医学中心进行IVF-ET治疗的4 205例不孕患者病历资料，根据受精情况分为完全受精失败组、低受精率组及对照组，分析3组相关临床资料[女方年龄、不孕年限、促排天数、促性腺激素(gonadotrophin，Gn)用量、卵泡刺激素(follicle-stimulating hormone，FSH)用量及总获卵数]之间的相关性；根据发病因素分为女方因素、男方因素及双方因素，分析不同组别之间发病因素的相关性；根据不孕类型分为原发不孕及继发不孕，分析不同组别之间不孕类型的相关性。采用多元线性逐步回归法分析IVF-ET中完全受精失败及低受精率的危险因素。结果: 原发不孕、不孕年限、总获卵数及双方因素与IVF-ET完全受精失败及低受精率的发生相关(均P<0.05)，但女方年龄、促排天数、FSH用量及Gn用量与IVF-ET完全受精失败及低受精率的发生不相关(均P>0.05)。多元线性回归分析示发病因素、不孕类型及不孕年限都是完全受精失败及低受精率的独立影响因素。结论: IVF-ET完全受精失败及低受精率的发生与不孕年限、总获卵数、发病原因和不孕类型等相关，未观察到与女方年龄、促排天数、Gn用量及FSH用量等相关。.
Keywords: fertilization failure; in vitro fertilization-embryo transfer; related factors.