精子畸形率对卵胞浆内单精子注射(ICSI)临床结局的影响

Impact of Sperm Malformation Rate on ICSI Clinical Outcomes

目的:分析畸形精子行卵胞浆内单精子注射(ICSI)的临床结局。方法:回顾性分析因男性因素行ICSI治疗的239个新鲜取卵周期。根据精子形态学分析结果将研究对象分为:精子形态正常组(A组)、非极重度畸形精子症组(B组)和极重度畸形精子症组(C组),比较3组的受精率、卵裂率、优质胚胎率、胚胎种植率及临床妊娠率、流产率、异位妊娠率和多胎妊娠率。结果:A、B组在受精率、卵裂率、优质胚胎率与C组有统计学差异(分别为80.20%、81.40%和67.60%;94.91%、93.42%和79.91%;63.87%、59.30%和54.29%)(P<0.05);3组的胚胎种植率、临床妊娠率、流产率、异位妊娠率、多胎妊娠率均无统计学差异(分别为26.3%、25.6%和24.2%;42.28%、45.00%和42.86%;7.94%、7.40%和25.00%;4.76%、3.70%和8.33%;31.75%、18.52%和25.00%)(P>0.05);而C组内手术取精(PESA/TESA)亚组的卵裂率低于体外排精亚组,差异有统计学意义(86.72%vs 76.11%,P<0.05)。结论:采用畸形精子行ICSI的不育患者同样可获得理想的临床结局。

Objective：To evaluate the efficacy of intracytoplasmic sperm injection（ICSI） in the treatment for teratospermia.Methods：A total of 239 cycles received ICSI because of male factors was analyzed by a retrospective study.They were divided into 3 groups：group A（normal sperm forms group）,group B（not severe teratospermia group） and group C（severe teratospermia group）.All the infertility patients were diagnosed by sperm morphology before ICSI.The rates of fertilization,cleavage,good quality embryos,embryo implantation,clinical pregnancy,miscarriage,ectopic pregnancy and multiple pregnancy were analyzed and compared among the three groups.Results：Compared with groups A and B,the rates of fertilization,cleavage,good quality embryos of group C showed statistically significant differences（80.20%,81.40% and 67.60%;94.91%,93.42% and 79.91%;63.87%,59.30% and 54.29%;respectively）（P0.05）.There were no significant differences on the rates of embryo implantation,clinical pregnancy,miscarriage,ectopic pregnancy and multiple pregnancy among the 3 groups（26.3%,25.6%,24.2%;42.28%,45.00%,42.86%;7.94%,7.40%,25.00%;4.76%,3.70%,8.33%;31.75%,18.52%,25.00%;respectively）（P0.05）.For group C,the rate of cleavage had significant differences between in vitro sperm row sub-group and PESA/TESA sub-group（86.72% vs 76.11%,P0.05）.Conclusion：The infertility patients who do ICSI by teratospermia can get relatively ideal clinical outcomes.