摘要
目的比较无精子症患者附睾或睾丸精子、重度少和(或)弱精子症患者精子以及非男方因素不育患者精子行卵胞浆内单精子注射(ICSI)后的临床治疗效果。方法非男方因素患者(n=62)和重度少和(或)弱精子症患者(n=102)采用射出的精子,无精子症患者(n=24)采用经皮附睾穿刺抽吸术(PESA)或睾丸穿刺抽吸术(TESA)获取精子,比较ICSI后的受精率、妊娠率和种植率等。结果非男方因素患者组女方年龄显著高于重度少和(或)弱精子症患者组以及无精子症患者组(P<0.05),然而三组患者的平均获卵数、MⅡ期卵数以及正常受精率差异无统计学意义(P>0.05)。非男方因素患者组的卵裂率显著高于无精子症患者组(P<0.05),但三组患者的优质胚胎率、临床妊娠率以及胚胎种植率差异均无统计学意义(P>0.05)。结论 PESA-ICSI和TESA-ICSI治疗部分无精子症患者可获得与重度少和(或)弱精子症患者甚至非男方因素不育患者同等的临床妊娠率和种植率,是治疗梗阻性和非梗阻性无精子不育症的有效手段。
Objective To compare the clinical outcomes of intracytoplasmic sperm injection （ICSI） using ejaculated sperm from severe oligospermia and/or asthenozoospermia patients, non-male factor patients with infertility and epididymal or testicular sperm from azoospermia patients. Methods ICSI was performed respectively with the sperm by ejaculation from non-male factor patients （n = 62） with infertility and severe oligozoospermia or asthenospermia patients （n = 102） , percutaneous epididymal sperm aspira- tion （PESA） or testicular sperm aspiration （TESA） from azoospermia patients （ n = 24 ） , and then the fertilization rate, the clinical pregnancy rate and the implantation rate were compared among the three groups. Results The age of female in non-male factor pa-tients with infertility was significantly higher than that in severe oligozoospermia or asthenospermia patients and azoospermia patients （P 〈 0.05 ） , although, there was no significant difference in the average number of ooeytes obtained, the number of M 11 oocytes, and the rate of normal fertilization oocytes （ P 〉 0.05 ）. The rate of cleavage in non-male factor patients with infertility was signifi-cantly higher than that in azoospermia patients （P 〈 0.05） , however, there was no significant difference in the rate of high quality embryo, clinical pregnancy rate and implantation rate （P 〉 0.05 ）. Conclusion PESA-ICSI and TESA-ICSI provide an effective treatment approach to partial azoospermia patients. It even can obtain a pregnancy rate similar to that of non-male factor patients with infertility. It may be applied to ICSI for treatment of obstructive and non-obstructive a＇zoospermic infertility patients.
出处
《临床军医杂志》
CAS
2013年第10期1060-1063,共4页
Clinical Journal of Medical Officers
关键词
不育症
无精子症
附睾精子
睾丸精子
弱精子症
infertility
azoospermia
epididymal sperm
testicular sperm
asthenozoospermia
