摘要
目的:分析精子的来源对卵胞质内单精子注射(ICSI)治疗结局的影响。方法:回顾性分析因男性不育行ICSI的3 106个新鲜周期,按精子来源分为:射精组(A组)、附睾穿刺取精(PESA)组(B组)、睾丸穿刺取精(TESA)组(C组)、冻融PESA精子组(D组)及冻融TESA精子组(E组),比较各组ICSI后胚胎发育及妊娠结局情况。结果:C组2PN受精率、卵裂率显著低于A组及B组;B组临床妊娠率、胚胎植入率显著高于A组及C组,A组、B组及C组间分娩率、异位妊娠率、流产率及新生儿畸形率无统计学差异(P>0.05);E组2PN受精率显著低于D组,但B组与D组之间、C组与E组间2PN受精率、优质胚胎率、多胎率、流产率及异位妊娠率均无统计学差异(P>0.05)。结论:PESA/TESA-ICSI、冻融PESA/TESA精子技术是治疗梗阻性无精子症安全有效的方法,建议首先选择附睾取精,并可将剩余PESA/TESA精子冻存。
Objective: To analyze the effect of sperm origin on pregnancy outcome after intracytoplasmic sperm injection (ICSI). Methods: A retrospective study was carried out on 3 106 fresh cycles which had under- gone ICSI treatment. Patients were divided into five groups according to the source of sperm: ejaculated sperm group (group A), percutaneous epididymal aspiration (PESA) group (group B), testicular sperm aspiration (TESA) group (group C), frozen-thawed epididymal sperm group (group D) and frozen-thawed testicular sperm group (group E). The embryonic development and pregnancy outcomes and other indicators were compared. Results: The rates of 2PN fertilization and cleavage were significantly higher in group A and group B than in group C. The rates of clinical pregnancy and embryo implantation were significantly higher in group B than in group A and group C. There was no significant difference among groups A, B, C in the rates of good-quality embryo, parturition, ectopic pregnancy, single fetal birth, multiple birth, miscarriage and neonatal malformation. The rate of 2PN fertilization was significantly higher in group D than in group E. There was no significant difference between groups D and E in the rates of 2PN fertilization, good-quality embryo, ectopic pregnancy and multiple birth and miscarriage. Conclusion: PESA/TESA-ICSI and ICSI using frozen-thawed sperm from PESA/TESA are effective methods to treat obstructive azoospermia, while PESA should be the first choice, and the rest of sperm from PESA/TESA should be cryopreserved.
出处
《生殖与避孕》
CAS
CSCD
2013年第4期233-238,共6页
Reproduction and Contraception