采用抽吸取精法结合单精子注射治疗无精子症结局

Study of PESA/TESA with ICSI in azoospermia patients

目的评价经皮附睾精子抽吸术(percutaneus epididymal sperm aspiration,PESA)或睾丸精子抽吸术(testicular sperm aspiration,TESA)结合卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗无精子症的临床效果。方法对290例因男性梗阻性及非梗阻性无精子症(non-obstructive azoospermia,NOA)采用PESA或TESA穿刺获取精子,女方采用长方案超排卵,然后对处于细胞分裂中期的成熟卵母细胞进行单精子注射。结果梗阻性无精子症组203例,受精率77.5%,临床妊娠率46.1%;非梗阻性无精子症组87例,受精率73.0%,临床妊娠率41.4%,两组比较其受精率及临床妊娠率均无显著性差异(P>0.05)。结论采用PESA或TESA获取精子结合ICSI是治疗梗阻性及非梗阻性无精子症等严重的男性不育症的一种有效的方法。

Objective ： To investigate the effect of PESA/TESA with ICSI for azoospermia patients. Methods ： 290 male cases with obstructive and non-obstructive azoospermia accepted PESA/TESA with ICSI, While their wives received conventional ovarian hyper-stimulation. All oocytes contained M Ⅱ were injected. Results： The fertility rate （FR） and clinical prognency rate （PR） in obstructive azoospermia men were 77.5 % and 46. 1% respectively; In non -obstructive azoospermia group, the FR and PR were respectively 73.0% and 41.4%. The two groups had no statistic difference （P 〉 0.05 ）. Conclusions： PESA/TESA with ICSI has provided a rapid, convenient and effective treatment for obstructive and non - obstructive azoospermia men.