经皮附睾穿刺精子活力对梗阻性无精子症患者卵泡浆内单精子注射临床结局的影响

The effect of percutaneous epididymal sperm motility on the clinical outcome of intracytoplasmic sperm injection in patients with obstructive azoospermia

目的探讨经皮附睾穿刺精子活力对梗阻性无精子症患者卵泡浆内单精子注射临床结局的影响。方法选取2010年1月-2016年12月期间我院收治的94例梗阻性无精子症患者,所有患者给予经皮附睾穿刺取精结合卵泡浆内单精子注射治疗,根据精子的活力,分为高活力组(n=76)和低活力组(n=18),比较两组患者的实验室结局指标和临床妊娠结局指标。结果高活力组患者正常受精率、卵裂率、可移植胚胎率以及优质胚胎率(78.2±11.7%,97.1±2.9%,66.8±14.9%和49.9±10.5%)均显著高于低活力组患者(70.5±10.2%,92.3±3.0%,58.6±12.6%和40.5±11.2%)(P<0.05);高活力组患者临床妊娠率和胚胎种植率(61.8%和36.5%)显著高于低活力组(27.7%和18.2%)(P<0.05)。结论经皮附睾穿刺所得精子的活力影响ICSI的临床结局,临床上应优先选择活力较好的精子行ICSI治疗。

Objective：To investigate the effect of percutaneous epididymal sperm motility on the clinical outcome of intracytoplasmic sperm injection in patients with obstructive azoospermia. Methods：During January 2010 to December 2016 in our hospital,94 cases of obstructive azoospermia patients weretreated with percutaneous epididymal sperm aspiration combined with intracytoplasmic sperm injection. According to the the vitality of the sperm,the patients were divided into high activity group（n=76）and low activity group（n=18）,to compare laboratory indexes of pregnancy outcome and clinical outcomes of two groups of patients. Results：the normal fertilization rate,cleavage rate,transplantable embryo rate and high quality embryo rate of high activity group（78.2±11.7%,97.1±2.9%,66.8±14.9% and 49.9±10.5%）was significantly higher than that in low activity group（70.5±10.2%,92.3±3.0%,58.6±12.6% and 40.5±11.2%）（P〈0.05）;the clinical pregnancy rate and embryo implantation rate of high activity groups of patients（61.8% and 36.5%）were significantly higher than that in low activity group（27.7% and 18.2%）（P〈0.05）. Conclusion：percutaneous epididymal sperm motility influenced the clinical outcome of ICSI. In clinic,we should give priority to choose ICSI with better vitality.