经皮穿刺输精管吸精子宫腔内授精治疗阻塞性无精症不育

Percutaneous vasal sperm aspiration and intrauterine insemination in the treatment of obstructive azoospermia

对２７６例无精症不育患者采用睾丸细针穿刺吸液细胞学检查，结合精液生化指标测定及双侧输精管通液或造影技术，６例诊断为双侧输精管盆部阻塞性无精症，经皮穿刺输精管吸精子（ＰＶＳＡ），有４例吸出活精子，２例吸出死精子，经孵育活化后，精子活率０％～４８％，畸形精子３１％～８２％，吸出液内总精子数（２～６０）×１０６，对３例吸出活精子患者行宫腔内人工授精（ＩＵＩ）４个月经周期，结果１例妊娠，并足月剖宫产一健康女婴，体重２６５０ｇ，身长４７ｃｍ。提示经皮穿刺输精管吸精子ＩＵＩ，可以做为输精管盆部阻塞性无精症不育患者一种有效的治疗方法。

Objective: To treat obstructive azoospermia by using percutaneous vasal sperm aspiration(PVSA) and intrauterine insemination(IUI).Setting: Shandong Institute of Family Planning.Design: Clinical study.Methods: Six men with obstructive azoospermia,three were treated with IUI,the spermatozoa used for IUI were retrieved by PVSA,and incubated at 37℃ for 40～60 min.Results: Intrauterine insemination was carried out in three patients for 1￣2 cycles,with motile spermatozoa.One successful term delivery was obtained.Conclusion: Percutaneous vasal sperm aspiration can be used successfully to recover sperm in men with obstructive azoospermia for use in IUI.The technique is simple and less traumatic as compared with an open surgical procedure.