冷冻精子复苏后授精方式的选择对供精IVF/ICSI助孕妊娠结局的影响OACSTPCD

Objective:To explore the impact of different insemination methods on the IVF/ICSI pregnancy outcome with donor cryopreserved-thawed sperm. Methods:The clinical data of 237 patients(243 oocyte retrieval cycles)who received IVF/ICSI assisted pregnancy with donor cryopreserved-thawed sperm at the Reproductive Medicine Center of the First Hospital of Lanzhou University from January 2019 to July 2022 were retrospectively analyzed.According to the insemination method,the cycles were divided into IVF group(108 oocyte retrieval cycles),ICSI group(67 oocyte retrieval cycles),and rescue ICSI(R-ICSI)group(68 oocyte retrieval cycles).The general information,ovulation induction status,embryonic development indicators and pregnancy outcomes of three groups of patients were analyzed. Results:There were no significant differences in age,body mass index(BMI),basal antral follicle count(AFC),duration of infertility,type of infertility,anti-Mullerian hormone(AMH),and basal sex hormones(FSH,LH,E2)among the three groups of patients(P＞0.05).There were no significant differences in Gn days,Gn dosage,E2 and progesterone levels on HCG day,number of oocytes retrieved,MⅡ oocyte number,2PN number,fertilization rate,and high-quality embryo rate among the three groups of patients(P＞0.05).The semen concentration,motility,and non-progressive motility sperm of patients in the ICSI and R-ICSI groups were significantly lower than those in the IVF group(P＜0.05).The progressive motility sperm of the ICSI group was significantly lower than that of the IVF and R-ICSI groups(P＜0.05),while the immobile sperm was significantly higher than that of the IVF and R-ICSI groups(P＜0.05).The number of available embryos and high-quality embryos in the ICSI group was significantly lower than that in the IVF and R-ICSI groups(P＜0.05).There were no significant differences in the number of embryos transferred,endometrial thickness on the transfer day and the ectopic pregnancy rate among the three groups(P＞0.05).The clinical pregnancy rate and cumulative live birth rate in the ICSI group were slightly lower than those in the IVF and R-ICSI groups,while the abortion rate and embryo demise rate were slightly higher than those in the other two groups,but the difference was not significant(P＞0.05). Conclusions:The embryo quality and pregnancy outcome of ICSI assisted pregnancy with cryopreserved-thawed sperm are slightly worse than those of conventional IVF and R-ICSI.The embryo quality and pregnancy outcome of R-ICSI assisted pregnancy are similar to those of IVF.It is recommended to choose IVF insemination as much as possible during the treatment of assisted pregnancy with donor sperm.If the expected IVF fertilization rate is low,R-ICSI assisted fertilization can be chosen.