远端输精管冲洗取精术联合ICSI治疗功能性不射精症6例报告

Sperm retrieval by the distal vas deferens washout combined with ICSI for the treatment of infertile males with psychogenic anejaculation(6 cases report)

目的:探讨远端输精管冲洗取精术联合卵泡浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗功能性不射精症(psychogenic anejaculation,PAE)性不育的疗效。方法:回顾性分析自2014年9月至2016年9月远端输精管冲洗取精术联合ICSI治疗6例PAE性不育的临床资料。结果:6例PAE患者行远端输精管冲洗取精术均可见精子,离心沉淀平均每高倍视野可见15~100条精子,其中活动精子占30%以上。6例PAE患者均冷冻了精子,有3例女性伴侣活产(其中2例还有冷冻胚胎),有2例女性伴侣怀孕中(其中1例还有冷冻胚胎),有1例胚胎移植失败(无冷冻胚胎)。结论:远端输精管冲洗取精术是一种安全、有效的较好取精方法,与ICSI联合治疗对于PAE导致的不育有效,甚至对其他类型的不射精症(如神经源性不射精症)导致的不育也有效。

Objectives： To explore the effectiveness of sperm retrieval by the distal vas deferens washout in combination with ICSI to treat infertile men with psychogenic anejaculation（ PAE）. Methods： The clinical data was retrospectively analyzed for the treatment of infertility by using the distal vas deferens washout to obtain sperm combined with ICSI in 6 men with PAE from September 2014 to September 2016. Results： In the sperm from the distal vas deferens washout,more than 30% with motility were found and frozen in 6 men with PAE,with 15-100 per high power field. In 6 patients with PAE,there were three couples with live births（ frozen embryos left in 2 cases）,two couples in pregnancy（ frozen embryos left in 1 case） and a failure of embryo transfer（ no frozen embryos） in one couple. Conclusion： Sperm retrieval by the distal vas deferens washout is a safe,effective and better way to obtain sperm. The distal vas deferens washout in combination with ICSI to treat infertile men with psychogenic anejaculation is effective and also suitable for other anejaculation such as neurogenic anejaculation.