摘要
【目的】分析辅助生殖治疗患者在获卵日由于男方取精失败,改行手术取精联合胞浆内单精子注射治疗后的妊娠结局;探讨获卵日男方取精失败的治疗方案。【方法】回顾性分析了2005年5月1日至2009年5月1日在我中心拟行辅助生殖治疗,在获卵日因男方取精失败而改行手术取精联合胞浆内单精子注射(ICSI)治疗的病例共33例;分成经皮附睾精子抽吸组(5例)和睾丸精子抽提组(28例)。分析ICSI后两组的受精率、卵裂率、优质胚胎率、种植率及妊娠率等结局。【结果】5年来,获卵日取精失败的发生率为0.52%(33/6341)。在33例患者中,经手术取精均成功获得精子,其中从附睾抽吸取精5例(15.2%,5/33),从睾丸抽提取精28例(84.8%,28/33)。ICSI后两组的受精率(69.2%vs78.6%,P=0.118)、妊娠率为(60.0%vs37.0%,P=0.374)和种植率(41.7%vs21.2%,P=0.129)之间差异无统计学意义。但两组的卵裂率(88.9%vs99.7%,P=0.019)与优质胚胎率(52.5%vs75.6%,P=0.004)之间的差异有统计学意义。32个周期行新鲜胚胎移植,有1个周期因为ICSI治疗后未受精没有移植,生化妊娠率为40.6%(13/32),种植率为24.4%(19/78),共获得14个活产儿。【结论】对于获卵日因男方取精失败的患者,改行手术取精联合胞浆内单精子注射是一种有效的办法,能避免因此取消周期。
[Objective] To evaluate the pregnancy outcomes of intracytoplasmic sperm injection（ICSI） with sperm obtained by surgical sperm retrieval in the men with ejaculation failure on the day of oocyte retrieval and to find out the protocol in case of ejaculation failure.[Methods] Retrospectively analyze 33 cases in our IVF center who had ejaculation failure on the day of oocyte retrieval and underwent surgical sperm retrieval combining with ICSI from May 1,2005 to May 1,2009.They were divided into percutaneous epididymal aspiration（PESA） group and testicular sperm extraction（TESE） group（28 cases）.The fertilization rate,cleavage rate,good quality embryos rate,pregnancy rate and implantation rate between the two groups were compared after ICSI.[Results] In the past five years,ejaculation failure occurred in 0.52%（33/6341） on the day of oocyte retrieval retrievals in our unit.All the 33 patients could retrieve sperm with surgical method successfully,including 5 cases from PESA（15.2%,5/33） and 28 cases from TESE（84.8%,28/33）.There were no statistically difference between the two groups in fertilization rate（69.2% vs.78.6%,P = 0.118）,pregnancy rate（60.0% vs 37.0%,P = 0.374） and implantation rate（41.7% vs 21.2%,P = 0.129）.But there were statistically significant difference between the cleavage rate（88.9% vs 99.7%,P = 0.019） and good quality embryos rate（52.5% vs 75.6%,P = 0.004） between the two group.Thirty-two cycles had fresh embryo transfer,only one cycle had no embryo transfer due to no fertilization after ICSI.The biochemical pregnancy rate and implantation rate were 40.6%（13/32） and 24.4%（19/78）,respectively.Fourteen babies were born.[Conclusion] Surgical sperm retrieval combining with ICSI is an effective solution for those men with ejaculation failure on the day of oocyte retrieval.It could avoid cancellation of treatment cycles.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2011年第4期500-504,共5页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省科技计划项目(2007B030502007
2007030500001)
关键词
取精失败
获卵日
经皮附睾精子抽吸术
睾丸精子抽提术
ejaculation failure
oocyte retrieval day
percutaneous epididymal sperm aspiration
testicular sperm extraction
