附睾穿刺取精行ICSI治疗梗阻性无精子症

Treatment of infertility due to obstructive azoospermiaby percutaneous epididymal sperm aspiration followed by intracy toplasmic sperm injection.

目的探讨附睾穿刺取精术(PESA)结合单精子卵胞浆内注射(ICSI)治疗梗阻性无精子症男性不育的可行性,并观察其临床效果。方法 7对夫妇为研究对象,男方均确诊为梗阻性无精子症,女方超促排卵获得卵细胞,男方于取卵日在局麻下通过细针穿刺附睾头部吸取少量精子,行ICSI,受精成功后24-48h,选择优质胚胎移植入子宫腔。因男性少弱精子症行ICSI治疗的20个治疗周期为对照组。结果附睾取精7例共11个治疗周期全部获得活动精子,ICSI后受精率65．9％,卵裂率98．3％,优质胚胎率71．9％,临床妊娠5例,周期临床妊娠率45．5％,与对照组比较,各项指标均无显著差异。结论附睾穿刺取得的精子与排出体外的精子具有相同的受精和获得优质胚胎的能力,PESA是治疗梗阻性无精子症男性不育的安全有效的方法。

Objective： To study the feasibility and the outcome of percutaneous epididymal sperm aspiration （PESA） followed by intracytoplasmic sperm injection （ICSI） from obstructive azoospermic men. Methods： 7 obstructive - azoospermic men received sperm retrieval through PESA. Then ICSI, culture and embryo transplantation procedures were performed. 20 ICSI cycles were determined to be the control group. Results ： All PESA were successful in 11 cycles of 7 cases. In PESA group, the fertilization rate, cleaver rate and pregnancy rate per cycle were 65.9%, 98. 3% and 45.5% respectively and were similar to those of the control group. Conclusion ： Sperms retrieved from PESA are active enough for fertilization. PESA is a noninvasive and simple technique for retrieving spermatozoa from obstructive azoospermic men. Therefore, it is suitable as the primary sperm recovery technique in patients with obstroctive azoospermia.