经皮睾丸穿刺取精行卵细胞质内单精子注射对梗阻性无精子症患者胚胎质量的影响

Effect of ICSI on the embryo quality in patients with obstructive azoospermia by TESA

目的研究经皮睾丸穿刺取精(TESA)行卵细胞质内单精子注射(ICSI)对梗阻性无精子症患者胚胎质量的影响。方法选取2014年1月至2019年1月河北省计划生育科学技术研究院诊治的571个因梗阻性无精子症行ICSI助孕治疗、女方年龄20岁~40岁的取卵移植周期作为研究对象。按照取精方法选择的不同分为TESA组(259个周期,行TESA取精)和对照组(312个周期,行传统睾丸活检术取精)。取精后行ICSI助孕。比较两组研究对象受精率、胚胎质量指标。结果TESA组正常受精率、2PN受精率和2PN卵裂率均高于对照组,差异均具有统计学意义(均P<0.05);TESA组可移植胚胎率、优质胚胎率和胚胎种植率均高于对照组,差异均具有统计学意义(均P<0.05)。结论TESA行ICSI技术可有效用于梗阻性无精子症的辅助受精,受精率高,胚胎质量较好。

Objective To study the effect of intracytoplasmic sperm injection(ICSI)on the quality of embryos in patients with obstructive azoospermia by testicular epididymal sperm aspiration(TESA).Methods 571 egg transfer cycles were selected retrospectively from female patients aged 20~40 with obstructive azoospermia treated with ICSI from January 2014 to January 2019.All the patients were divided into the control group(312 egg transfer cycles)and the TESA group(259 egg transfer cycles).The patients in the control group were treated with traditional testicular biopsy,and the patients in the TESA group were treated with TESA,and ICSI was used to assist pregnancy after sperm extraction.The fertilization rate and embryo quality index in the two groups were evaluated and compared.Results The normal fertilization rate,2 PN fertilization rate,2 PN cleavage rate,transplantable embryo rate,high-quality embryo rate,and embryo implantation rate of TESA group were all higher than those of the control group,with statistically significant differences(all P<0.05).Conclusions ICSI through TESA can effectively treat obstructive azoospermia,which has high fertilization rate and good embryo quality.