不同来源精子行ICSI助孕1662个周期治疗结局分析

Clinical outcome analysis different sources of sperm in 1662 intracytoplasmic sperm injection cycles

目的：探讨不同来源精子行卵胞浆内单精子显微注射（ICSI）助孕的妊娠结局。方法：回顾分析我中心2006年1月～2010年6月1662个ICSI治疗周期，按精子来源分为射出精子来源（重度少、弱精子）组1208周期，附睾穿刺取精（PESA）组324周期，睾丸穿刺取精（TESA）组130周期，比较3组胚胎发育情况和妊娠结局等指标。结果：射出精子组及PESA组受精率、卵裂率及2PN率较TESA组高（79．1％，77．9％VS73．9％；98．7％，98．8％VS96．6％：74．6％，73．0％vs69．5％），TESA组1PN率较射出精子组及PESA组高（3．8％ vs 2．2％，2．6％），差异均有统计学意义（P〈0．05）；3组优质胚胎率、胚胎种植率、临床妊娠率、异位妊娠率、流产率、单胎出生率、双胎出生率、畸形率无统计学差异。结论：PESA及TESA来源精子行ICSI助孕可获得与射出精子相似的妊娠结局。

Objective：To analyze the clinical outcomes of intraeytoplasmic sperm injec- tion（ICSI） use different sources of spermatozoa. Methods：This retrospective study was carried out on 1662 couples who underwent ICSI in our center from January 2006 to June 2010. It included 1208 men with severe oligozoospermia or asthenospermia using ejaculated sperm. The 324 men with azoospermia underwent pereutaneous epididymal aspiration（PESA） and 130 men underwent testicular sperm extraction （TESE）. The embryos development and pregnancy outcomes and other indicators in the 3 groups were compared. Results：The rate of fertilization, cleavage and 2PN were significantly higher in the ejaculated sperm and PESA groups than in the TESA group（79.1% ,77.9% vs 73.9% ;98.7% ,98.8% vs 96.6% ;74.6% ,73.0 % vs 69.5% ） ,the 1PN rate was significantly higher in the TESA group than in the ejaculated sperm and PESA groups. But there are no significant differences among 3 groups in the rate of high quality embryos, embryo implantation, clinical pregnancy, miscarriage, ectopic pregnancy, single fetal birth,twin birth,malformation. Conclusion：The pregnancy outcome of ICSI treatment with PESA and TESA is similar to the ejaculated sperm.