不同来源精子对ICSI治疗后妊娠结局的影响

Sperm origin and quality effect on pregnancy outcome after intracytoplasmic sperm injection

目的分析不同精子来源和数量对单精子卵胞浆内注射术(ICSI)妊娠结局的影响。方法2000年1月～2005年1月在本中心进行ICSI治疗而妊娠的354例,据精子来源与数量分为精液正常组(47例)、少弱精子组(194例)与手术取精子组(113例)。比较3组的临床妊娠率、流产率、分娩率、妊娠并发症、分娩孕周、新生儿出生体重、畸形、围产期死亡率等组间差异。结果3组患者的年龄、不孕年限、临床妊娠率(41.3%、39.7%、40.4%)、流产率(14.9%、18.6%、15.9%)、分娩率(78.7%、75.8%、79.6%)、双胎率(34.4%、35.4%、37.8%)、妊高症发生率(10.8%、10.2%、11.1%)、前置胎盘发生率(5.4%、6.8%、6.7%)、早产率(27.0%、27.9%、27.8%)、分娩孕周(36.4±5.4)w、(37.6±2.3)w、(37.2±2.8)w、胎儿出生体重(2765.4±624.9)g、(2749.0±523.5)g、(2763.5±684.4)g、先天性畸形发生率(4.5%、5.0%、4.0%)、围产期死亡率(40‰、45‰、48‰),差异均无显著性(P>0.05)。结论不同精子来源与数量不影响ICSI治疗后的妊娠和围产儿结局。

Objective To analysis the effect of sperm origin and quality on pregnancy outcome after intracytoplasmic sperm injection. Methods A retrospective study was carried out to measure pre-clinical and clinical abortion, delivery, pregnant complications, gestational age, birth weight, malformation and perinatal mortality in patients receiving normal sperm （n=47, groupyl）, oligoasthenozoospermia （n=194, groupy2） and surgically obtained sperm （n=113, groupy3） between January 2000 and January 2005. Results The maternal age, infertih＇ty duration were comparable among three groups. There were no significant differences of clinical pregnancy rate （41.3%vs39.7%vs40.4%）, abortion rate （14.9%vs 18.6%vs 15.9%）, birth rate （78.7%vs75.8%vs79.6%）, twin gestation rate （34.4%vs35.4%vs37.8%）, pregnancy-induced hypertension rate （10.8%vs 10.2%vs 11.1%）, placenta praevia rate （5.4%vs6.8%vs6.7%）, premature birth rate （27.0%vs27.9%vs27.8%）, gestational age （36.4±5.4）w vs （37.6±2.3）w vs（37.2±2.8）w, birth weight （2765.4±624.9）g vs （2749.0±523.5）g vs （2763.5±684.4）g, malformation rate （4.5%vs 5.0%vs4.0%）, perinatal mortality rate （40%ovs45%ovs48%o） among three groups （P〉0.05）. Conclusion The pregnancy and perinatal outcome after ICSI is neither affected by the origin of sperm nor by the quality of sperm in the ejaculate.