补肾生精汤与卵胞浆内单精子注射治疗男性严重少、弱精子症不育的临床观察

Male Infertility with Severe Oligospermatism and Azoospermia Treated by Bushen Shengjing Decoction Combined with Intracytoplasmic Sperm Injection

目的观察中药补肾生精汤与卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗男性严重少、弱精子症不育患者助孕疗效。方法服用中药补肾生精汤2～3个月后应用ICSI(中药组,82例)与单独应用ICSI(对照组,82例)助孕技术治疗男性严重少、弱精子症。观察中药组患者用药前后精液常规指标(精子密度、活率、活力、畸形率),活性氧,获得卵子数、MⅡ卵子数、受精率、卵裂率、可用胚胎率、平均移植胚胎数、临床妊娠率。结果中药组患者治疗后精子密度、活率、活力提高,畸形率及活性氧水平下降(P<0.05),且卵子受精率〔85.9%(438/510)〕和临床妊娠率〔48.7%(38/78例)〕明显高于对照组〔卵子受精率77.9(394/506),临床妊娠率32.5%(25/77例)〕(P<0.05)。结论中药补肾生精汤能够明显降低精液中活性氧水平,提高精子质量,并有助于严重少、弱精子症患者自然受孕和提高ICSI治疗时患者精子活力、卵子受精率及临床妊娠率。

Objective To observe the pregnancy promoting effect of Bushen Shengjing Decoction （BSSJD） combined with intracytoplasmic sperm injection （ICSI） in treating male infertility with severe oligospermatism and azoospermia （SOA）. Methods ICSI were applied on 164 patients, among them, the 82 assigned to the TCM group were treated with additionally by BSSJD before injection for 2-3 months, and the other 82 assigned to the control group received ICSI alone. The density, motility, viability and deformity of sperm; semen level of reactive oxygen species （ROS） ; number of eggs retrieved, M Ⅱ eggs and mean transplanted fetus; rates of fer- tilization, cleavage, available embryo and clinical pregnancy in the two groups were observed and compared. Re- suits Compared with those in the control group, the density, motility and viability of sperm were higher, the deformity rate and ROS level were lower in the TCM group respectively （P 〈 0.05）. Moreover, higher rates of fertilization and clinical pregnancy were also shown in the TCM group （P〈0.05）. Conclusion BSSJD has the effects of decreasing semen level of ROS and improving the quality of sperm. It is also helpful for the natural fer- tilization ability of patients with SOA and raise the viability of their sperm to increase the ovarian fertilization rate and clinical pregnancy rate in ICSI cycles.