İntrasitoplazmik sperm enjeksiyonu (ICSI) uygulanan infertil kadınlarda gebelik başarısını etkileyen faktörlerin değerlendirilmesi

Yıl 2021, Cilt: 14 Sayı: 3, 748 - 759, 01.07.2021

Ümit Çabuş Nazlı Çil Cihan Kabukçu

https://doi.org/10.31362/patd.899781

Öz

Amaç:
Çalışmamızın amacı, yardımcı üreme tekniği olarak intrasitoplazmik sperm enjeksiyonu uygulanan infertil kadınlarda gebelik başarısını etkileyen faktörlerin değerlendirilmesidir.
Gereç ve yöntem:
Ocak 2018 ve Aralık 2020 tarihleri arasında, intrasitoplazmik sperm enjeksiyonu uygulanan, tek ve taze embriyo transferinin yapıldığı toplam 283 infertil hastaya ait 325 siklus çalışmaya dâhil edildi. Hastaların yaşı, vücut kitle indeksleri, infertilite nedenleri, kaç adet oosit toplandığı ve maturasyon oranı, embriyo transfer günü endometriyal kalınlık, embriyonun kalitesi ve kaçıncı gün transfer edildiği belirlendi. Ayrıca hastaların Anti-Müllerian Hormon (AMH), bazal FSH, LH, estradiol (E2) düzeyleri, Human Chorionic Gonadotropin (hCG) uygulandığı gün E2 ile progesteron (P) düzeyleri ve gebelik sonuçları değerlendirildi.
Bulgular:
Gebelik oluşan sikluslarda (n:141), oluşmayan sikluslara (n:184) kıyasla kadın yaşı (p=0,015), bazal FSH seviyesi (p=0,005), AMH (p=0,002), elde edilen oosit sayısı (p=0,003), MII oosit sayısı (p=0,001 ), embriyo kalitesi (p<0,001 ) ve 5. gün embriyo transfer oranı (p<0,0001 ) istatiksel olarak anlamlı bulundu. VKİ (p=0,814), bazal E2 seviyesi (p=0,411), hCG günü E2 (p=0,056) ve P seviyesi (p=0,119), ET günü EMK (p=0,146), oosit maturasyon indeksi (p=0,140) ve total pogressif motil sperm sayısı (p=0,747) açısından her iki grup arasında anlamlı bir farklılık gözlenmedi. İnfertilite nedenlerinin gebelik oluşumuna etkisi değerlendirildiğinde gruplar arasında anlamlı fark olmadığı izlendi.
Sonuç:
ICSI uygulanan infertil kadınlarda gebelik başarısını öngörmede en önemli prognostik faktörler maternal yaş, embriyo kalitesi ve transfer günüdür.

Anahtar Kelimeler

İnfertilite, İntrasitoplazmik sperm enjeksiyonu, Embriyo kalitesi, Gebelik

Teşekkür

Pamukkale Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum AD, Histoloji ve Embriyoloji AD ve Yardımcı Üreme Teknikleri Merkezinde çalışan başta Prof. Dr. Babür Kaleli, Prof. Dr. S. Erkan Alataş, Prof. Dr. İ. Veysel Fenkçi ve Prof. Dr. Gülçin Mete hocalarımız olmak üzere tüm çalışma arkadaşlarımıza teşekkür ederiz.

Evaluation of factors influencing pregnancy success rate in infertile women who underwent intracytoplasmic sperm injection (ICSI)

Öz

Purpose:
The aim of our study is to evaluate the factors affecting pregnancy success rate in infertile women who underwent intracytoplasmic sperm injection as an assisted reproductive technique.
Materials and methods:
Between January 2018 and December 2020, 325 cycles of 283 infertile patients who underwent intracytoplasmic sperm injection and a single fresh embryo transfer were included in the study. Age of patients, BMI, causes of infertility, number of collected oocytes and maturation rate, endometrial thickness on embryo transfer day, quality of embryo and transfer day were determined. In addition, anti-Müllerian Hormone, basal FSH, LH, estradiol (E2) levels and E2 and progesterone (P) levels on the day of Human Chorionic Gonadotropin (hCG) administration and pregnancy outcomes were evaluated.
Results:
Age of women (p=0.015), basal FSH level (p=0.005), AMH (p=0.002), number of oocytes obtained (p=0.003), number of MII oocytes (p=0.001), embryo quality (p<0.001) and embryo transfer rate on fifth day (p<0.0001) were found to be statistically significant in cycles resulting in a pregnancy (n:141) compared to nonsuccesful cycles (n:184). BMI (p=0.814), basal E2 level (p=0.411), E2 (p=0.056) and P (p=0.119) levels on hCG day, EMT (p=0.146) on ET day, oocyte maturation index (p=0.140) and total progressive motile sperm count (p=0.747) were not significantly different between the groups. When the effects of infertility causes on pregnancy succes rate were evaluated, there was no significant differences between the groups.
Conclusion:
The most important prognostic factors in predicting pregnancy success rate in infertile women who underwent ICSI are maternal age, embryo quality and transfer day.

Anahtar Kelimeler

Infertility, Intracytoplasmic sperm injection, embryo quality, pregnancy

Kaynakça

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