利用附睾或睾丸精子行卵胞浆内单精子注射治疗阻塞性无精子症

Treatment of obstructive azoospermic patients by intracytoplasmic injection of epididymal or testicular sperm

目的回顾性分析38例阻塞性无精子症(OA)患者利用附睾或睾丸精子行卵胞浆内单精子注射(ICSI)的治疗结局。方法OA患者通过经皮附睾精子抽吸术(PESA)或睾丸切开取精术(TESE)获得精子行ICSI,评估受精率及临床妊娠率,以精液精子行ICSI组为对照。结果OA组38例共41个治疗周期,受精率和临床妊娠率分别为73.3%和53.6%,精液精子组31例33个治疗周期受精率和临床妊娠率分别为75.1%和48.4%,两组间比较,受精率和临床妊娠率差异无统计学意义(P>0.05)。OA组共妊娠22例,已分娩13例,流产6例,继续妊娠3例;精液精子组共妊娠16例,已分娩10例,流产1例,继续妊娠5例。结论采用附睾/睾丸精子行ICSI是治疗男性阻塞性无精子症的有效方法。

Objective To review the treatment results of intracytoplasmic injection（ICSI） of epididymal or testicular sperm obtained from 38 obstructive azoosperrnic patients. Methods Sperm was retrieved by percutaneous epididymal sperm aspiration（PESA） or testicular sperm extraction（TESE）. Intracytoplasmic injection was performed. The rates of fertilization and clinical pregnancy were evaluated. Control group was set up in which intracytoplasmic injection was performed using sperm of ejaculation. Re,lairs Forty-one treatment cycles were performed in the 38 obstructive azoospermc patients. The rates of fertilization and clinical pregnancy were 73.3 % and 53.6 %. Thirty-three treatment cycles were done in the 31 ejaculatory ones. The rates of fertilization and clinical pregnancy were 75.1% and 48.4 %. No significant difference was seen between the two groups. In the obstructive azcospermia group, 22 clinical pregnancies were achieved including 13 live deliveries and 3 ongoing pregnancies and 6 miscarriages. In the ejaculatory group, 16 clinical pregnancies were achieved including 10 live deliveries and 5 ongoing pregnancies and 1 miscarriages. Conclusions ICSI with PESA or TESE is an effective method for treatment of obstructive azoospermic patients.