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clinical value of late icsi after routine ivf failure：a systematic review.doc

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clinical value of late icsi after routine ivf failure：a systematic review

精品论文参考文献 Clinical value of late ICSI after routine IVF failure：a systematic review 　Reproductive Medical Center，TongjiHospital，Tongji University，Shanghai 200065 　　Abstract：Objective：To explore the efficacy and the clinical value of late- intracytoplasmic sperm injection in case of standard in vitro fertilization failure.Methods：Articles about rescue intracytoplasmic sperm injection（rescue-ICSI）performed after standard in vitro fertilization failure（IVF）from January 2009 through February 2016 were retrieved from Ovid MEDLINE，EM-BASE and CNKI by randomized controlled trials（RCT）and reference documents of selected literature were also retrieved by hand. The quality evaluation of selected literature was performed byMeta analysis. Results：A total of 10 articles were included out of which 7 were RCT between ICSI and rescue-ICSI. The other 3 were RCT between early-ICSI and late-ICSI. There were 5 articles of quality B and 5 articles of quality C. Fertilization rate，cleavage rate and pregnancy rate in rescue-ICSI group were significantly lower than those in normal ICSI group while the abnormal fertilization rate were significantly higher than that in ICSI group（Plt;0.05）. Fertilization rate，embryo quality and pregnancy rate were higher in early-ICSI group than those in late-ICSI group. The difference is statistical significance（Plt;0.05）；The abnormal fertilization rate and cleavage rate were higher in early rescue ICSI but the differences had no statistical significance（Pgt;0.05）.Conclusion：Clinical outcome is comparatively low in late-ICSI than ICSI group. However late-ICSI provides pregnancy in some cases with total fertilization failure（TFF）in same cycle. Late-ICSI should be practiced and can be considered an option in case of TFF. 　　Key words：in vitro fertilization，total fertilization failure，rescue-ICSI，late-ICSI 　　　　　　Introduction：　　Unexpected failure to achieve fertilization during an IVF cycle where the sperm seems to be normal not only gives patient emotiona