卵胞浆内单精子注射64个周期临床分析

Analysis of 64 Cycles of Intracytoplasmic Sperm Injection in Treating Male Infertility

目的回顾我中心卵胞浆内显微单精子注射技术（ICSI）治疗男性严重少弱精症的临床治疗效果，比较女方年龄和不同精液参数对ICSI结局的影响。方珐以2004年8月-2008年4月接受ICSI治疗的64个周期57对不育患者为研究对象，分析女方不同年龄组（≤30岁组、31-35岁组、36～40岁组）和男方不同精液参数（正常精液组、严重少弱畸精子组、附睾睾丸穿刺取精组）患者ICSI后的受精率、卵裂率、优胚率、临床妊娠率的比较。结果（1）64个周期中获卵数为817个，其中成熟卵母细胞（MII）661个，受精率为82．75％，卵裂率为89．76％，优胚率为68．63％，临床妊娠率为39．06％。（2）女方≤30岁组、31—35岁组、36～40岁组ICSI的受精率分别为83．9％、85．5％、72．4％，三组比较差异有统计学意义（P〈0．01）；三组卵裂率分别为91．4％、91．2％、76．4％，优胚率分别为73．8％、67．1％、54．8％，三组妊娠率分别为35％、53．1％、10％，三组的卵裂率、优胚率、妊娠率比较差异均有统计学意义（P〈0．05）。（3）男方正常精液组、严重少弱畸精子症组、附睾睾丸穿刺取精组患者受精率分别为83．3％、83．1％、75．0％，卵裂率分别为96％、95．1％、91．7％，优胚率分别为70．8％、65．6％、68．2％，三组受精率、卵裂率、优胚率比较差异均无统计学意义（P〉0．05）。结论女方年龄因素对ICSI妊娠结局有显著影响，男方精液参数的不同对ICSI结果无显著影响。

To review the Clnical effect of intracytoplasmic sperm injection（ICSI） in treatment of male infertility involve oligoasthenozoospermic and testicular or epididymal sperm. Methods All matured oocytes were injected with a single sperm. The embryos were transferred back to the uterine 3rd day after insemination. Results There were 661 matured oocytes obtained in 64 cycles, the insemination rate and clinic pregnant rate were 82.75 % and 39.06 % respectively. Conclusion ICSI is an effective method for male infertility, including oligoasthenozoospermic and testicular or epididymalsperm. With the growth of age, number of oocyctes retrieved decreased and embyros implantation rate got lower significantly. Quantity and source of sperm had no effection on fertilizing and segmentation of ovum.