左旋肉碱在经皮附睾穿刺取精-卵细胞胞质内单精子注射治疗中的应用

Use of L-carnitine before percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection for obstructive azoospermia

目的:探讨左旋肉碱在经皮附睾穿刺取精-卵细胞胞质内单精子注射(PESA-ICSI)治疗中的应用。方法:随机将2008年9月至2009年8月间本中心就治的79例梗阻性无精子症患者分成2组:未服药组(A组36例)和服药组(B组43例)。B组ICSI治疗取卵前3个月口服左旋肉碱(1g,2次/d)治疗,A组未作任何治疗作为对照,比较A、B两组间PESA-ICSI的获卵数、受精数、受精率、优质胚胎数和优质胚胎率。结果:A、B两组间受精数和受精率无显著性差异,但B组获得优质胚胎数及优质胚胎率明显高于A组(P<0.05)。结论:ICSI治疗前不育男性口服左旋肉碱3个月能显著提高PESA-ICSI的优质胚胎数及优质胚胎率,为将来获得良好的妊娠结局奠定基础。

Objective：To explore the use of L-carnitine before percutaneous epididymal sperm aspiration-intracytoplasmic sperm injection （PESA-ICSI） in the treatment of obstructive azoospermia. Methods：Seventy-nine cases of obstructive azoospermia treated in our center from Sep 2008 to Aug 2009 were divided into an L-carnitine （n = 43） and a control group （n = 36）,the former given oral L-carnitine at 1 g bid for 3 months before PESA-ICSI,while the latter left untreated. Comparisons were made between the two groups in the number of retrieved oocytes and fertilized oocytes as well as the number and rate of good embryos. Results：There were no significant differences between the two groups in the number of retrieved oocytes and fertilized oocytes. But the number and rate of good embryos were significantly higher in the L-carnitine than in the control group （P 0.05）. Conclusion：Three-month oral medication of L-carnitine before PESA-ICSI can raise the number and rate of good embryos in obstructive azoospermia patients and therefore benefit the therapeutic outcome.