摘要
目的分析单纯男方因素不育(少弱精子症、无精子症)患者卵胞浆内单精子显微注射(ICSI)助孕结局。方法回顾性分析2015年1月至2019年11月期间在天津市第一中心医院生殖医学科接受ICSI治疗的338个新鲜移植周期,依据精子来源分为少弱精子组167周期、重度少弱精子组92周期,经皮附睾穿刺取精(PESA)组33周期,睾丸精子抽吸(TESA)组24周期,显微取精(MD-TESE)22周期。比较五组正常受精(2PN)率、优质胚胎率、可利用胚胎率、临床妊娠率、种植率、早期流产率。结果少弱精子组、重度少弱精子组、PESA组、TESA组、MD-TESE组2PN受精率分别为82.83%、83.94%、80.41%、78.54%、73.02%,MD-TESE组与其他四组相比差异有统计学意义(P=0.04),其他四组间2PN受精率差异无统计学意义(P>0.05);五组间优质胚胎率、可利用胚胎率、囊胚形成率、早期流产率差异无统计学意义(P>0.05),重度少弱精子组临床妊娠率、种植率、低于其他四组,但差异无统计学意义(P>0.05)。结论少弱精子、无精子症患者用不同来源精子行ICSI,对优质胚胎率、可利用胚胎率、临床妊娠率、种植率、早期流产率均无显著影响,可获得较好临床结局。
Objective To analyze the pregnancy outcomes of ICSI in infertility patients with oligoasthenospermia and azoospermia.Methods A retrospective study was carried out in 338 patients who received intracytoplasmic sperm injection(ICSI)assisted reproduction treatment in the Department of Reproductive Medicine of Tianjin First Central Hospital from January 2015 to November 2019.According to the sperm sources,they were divided into five groups such as the oligoasthenospermia group with 167 cycles,severe oligoasthenospermia group with 92 cycles,the percutaneous epididymal sperm extraction(PESA)group with 33 cycles,the testicular sperm aspiration(TESA)group with 24 cycles,and the microdissection testicular sperm extraction(MD-TESE)group with 22 cycles.The normal fertilization(2PN)rate,quality embryo rate,available embryo rate,clinical pregnancy rate,implantation rate and early abortion rate of the five groups were comparatively analyzed.Results The 2PN fertilization rates of the oligoasthenospermia group,the severe oligoasthenospermia group,the PESA group,the TESA group and the MD-TESE group were 82.83%,83.94%,80.41%,78.54%and 73.02%respectively.The 2PN fertilization rate of the MD-TESE group was significantly lower than that of the other four groups(P=0.04).However,2PN fertilization rates among the other four groups had no significant difference(P>0.05).The rate of high-quality embryos,available embryos,blastocyst formation rate and early abortion rate also had no significant differences among the five groups(P>0.05).The clinical pregnancy rate and implantation rate of the severe oligoasthenospermia group were lower than those of the other four groups,but the differences were not statistically significant(P>0.05).Conclusion Sperm from different sources for ICSI in patients with oligoasthenospermia and azoospermia had no significant effect on the rate of high-quality embryos,available embryos,clinical pregnancy,implantation and early abortion,indicating that better clinical outcomes could be obtained.
作者
刘丽
曹晓敏
张暄琳
邸建永
徐凤琴
Liu Li;Cao Xiaomin;Zhang Xuanlin;Di Jianyong;Xu Fengqin(Department of Reproductive Medicine,First Central Hospital,Tianjin 300192,China)
出处
《中国男科学杂志》
CAS
CSCD
2020年第5期21-25,共5页
Chinese Journal of Andrology
关键词
少弱精子症
无精子症
卵胞浆内单精子显微注射
妊娠结局
Oligoasthenospermia
Azoospermia
Intracytoplasmic sperm injection(ICSI)
Pregnancy outcomes
