重度少、弱、畸精症及阻塞性无精症患者单精子卵胞浆内注射治疗结果分析

Evaluation of treatment of intracytoplasmic sperm injection for infertility of severe oligo-astheno-teratospermia and obstructive azoospermia

目的 回顾性分析应用单精子卵胞浆内注射 (ICSI)技术治疗重度少、弱、畸精症及阻塞性无精症性不育的临床效果。方法 收集 2 0 0 1年 5月～ 2 0 0 3年 3月在我中心接受ICSI技术治疗的 2 9例 (31个周期 )重度少、弱、畸精症及 8例 (9个周期 )阻塞性无精症患者为研究对象 ,长方案进行超促排卵 ,ICSI常规操作 ,分析体外排精组和附睾取精组ICSI后的妊娠结局。结果 4 0个周期共获卵 372枚 ,平均获卵9 3± 5 36枚 ,其中可注射的MⅡ成熟卵 32 6个 (87 6 % ) ,注射后存活卵 30 6枚 (93% )。受精率 78 6 % (2 4 1/ 30 6 ) ,胚胎形成率 89% (2 15 / 2 4 1) ,优质胚胎形成率 39% (84 / 2 15 ) ,平均移植胚胎数 2 73± 0 85 ,周期生化妊娠率 35 % ,临床妊娠率 2 7 5 %。 1例 3胎、3例双胎 ,多胎率 36 % ,目前已全部出生 ,共诞生了 16名健康婴儿。结论 ICSI技术是治疗重度少、弱、畸精症及阻塞性无精症性不育的有效手段。

Objective To evaluate the efficacy of intracytoplasmic sperm injection (ICSI) in the treatment for infertility of severe oligo-astheno-teratospermia and obstructive azoospermia. Methods One group of 29 couples (31 cycles) because of severe oligo-astheno-teratospermia and another group of 8 couples(9 cycles) because of obstructive azoospermia received ICSI. Ovarian stimulation was achieved by conventional long-protocal. Only matured oocytes were selected for ICSI. The pregnancy rate of the 2 groups was analyzed. Results The total number of oocytes collected was 372,average number of oocytes was 9.3±5.36 each cycle. Injectable oocytes accounted for 326(87.6%) and fertilized oocytes was 241(78.6%). Embryos developed added up to 215(89%), of which 84(39%) had good morphology. The average number of embryo transfer was 2.73±0.85. The clinical pregnancy rate was 27.5%. 16 healthy babies of 11 couples were delivered. Conclusion ICSI is an effective treatment for infertility of severe oligo-astheno-teratospermia and obstructive azoospermia.