单精子卵胞浆内穿刺术治疗男性不育症的探讨(附23例报告)

Intracytoplasmic sperm injection for treatment of severe male infertility (Report of 23 cases)

目的 :探讨单精子卵胞浆内穿刺术 (ICSI)治疗严重精液异常和梗阻性无精子症所致不育的疗效。方法 :对 2 3例严重精液异常和梗阻性无精子症患者施行 ICSI,女方行常规超促排卵以获取卵子并选择成熟的卵母细胞 ,同时采用手淫法、经皮附睾穿刺术 (PESA)和睾丸精子获取术 (TESE)以获得精液、附睾及睾丸精子行ICSI。结果 :2 3例 2 3个治疗周期共获卵 332个 ,其中 30 0个成熟卵母细胞进行了 ICSI,193(6 4.3% )个卵子正常受精 ,形成 180个胚胎 ,每个治疗周期移植胚胎 2～ 4个 (平均 3.0 7个 ) ,8例获得临床妊娠 ,2例系双胞胎 ,总周期临床妊娠率为 34 .8%。其中 11例 11个治疗周期采用精液精子行 ICSI,4例妊娠 ;12例 12个治疗周期采用附睾精子或睾丸精子 ,4例妊娠。结论 :ICSI可以有效地治疗严重的精液异常和梗阻性无精子症所致的不育症。

Purpose:To investigate the efficacy of ICSI treatment for severe male factor infertility. Methods: The female partners were routinely superovulated and had oocyte retrieval under transvaginal ultrasound. MII oocyte was selected to be microinjected with a single spermatozoon, which was prepared from semen, PESA and TESE samples respectively . Results: Among 332 oocytes retrieved, 300 MII oocytes were microinjected, 193 ( 64.3 %) oocytes were normally fertilized, 180 fertilized oocytes cleaved to embryos. 2～4 (mean 3.07) embryos were replaced into uterus for each transfer. 8 clinical pregnancies (2 twin) were achieved, with a pregnant rate per cycle of 34.8%. 4 pregnancies resulted from 11 ICSI cycles with semen spermatozoa and 4 from 12 cycles with epididymal or testicular spermatozoa. Conclusions: ICSI is an effective method to treat severe male infertility.