摘要
目的了解先天性双侧输精管缺如（CBAVD）小育患者附睾精子功能及经皮穿刺附睾吸精后，子宫腔内人工授精（IUI）和卵浆内单精子显微注射（ICSI）的效果。方法对78例CBAVD不育患者进行经皮穿刺附睾吸精子（PESA），对吸出的精子进行精子低渗膨胀实验（HOST）、IUI、ICSI。结果附睾头部PESA精子活率、畸形率、密度、总精予数及HOST膨胀率分别为（18．43±11.2）％、（56.1±21．3）％、（26．0±14．0）×10^6／ml、（18．3±11．1）×10^6及38％±18％，而附睾尾部PESA精子各项指标分别为（8．3±7．2）％、（78．2±32．0）％、（9．0±12．0）×10^6／ml、（10．2±10.8）×10^6及（16．0±14．0）％，PESA附睾尾部的精子活率、密度、总精子数及HOST膨胀率都明显低于附睾头部的精予（P〈0．01），畸形精子比率明显高于附睾头部的精子（P〈0．01）。PESA-IUI及PESA-ICSI-IVF-ET分别有2例和6例妊娠，周期妊娠率分别为3．8％和33．3％。结论（1）CBAVD患者附睾尾部精子质量明显低于附睾头部精子：（2）PESA—IUI及PESA—ICSI—IVF，ET是CBAVD不育患者治疗较为有效的方法。
Objective To investigate the epididymal sperm function of infertile males with congenital bilateral absence of the vas deferens （CBAVD） and the clinical pregnancy by intrauterine insemination （IUI） and intracytoplasmic sperm injection （ICSI） with percutaneous epididymal sperm aspiration （PESA）. Methods Seventy-eight infertlie men with CBAVD were performed with PESA and treated with IUI ICSI and in vitro fertilization embryo transfer （IVF-ET） using the retrieved sperm. Sperm membrane function was tested by hypo-osmotic swelling test HOST. Results The motility, the rate of terato-sperm, the density, the total sperm per PESA and the rate of HOST of caput sperm by PESA were （18.4±11.2）%, （56.1±21.3）%, （26.0±14.0）× 10^6/ml, （18.3±11.1）× 10^6 and （38.0±18.0）%, respectively, while these parameters of cauda sperm by PESA were （8.33±7.2）%, （78.2±32.0）%, （9.03±12.0）× 10^6/ml, （10.2±10.8） × 106 and （16.0± 14.0）%, respectively. There were significant differences （P〈0.01） between the quality of sperms from caput and cauda by PESA. The cyclic pregnancy rate of the IUI and ICSI-IVF-ET was 3.8% and 33.3%, respectively. Conclusion The function and quality of caput sperm were better than that of cuada sperm in males with CBAVD. PESA-IUI and PESA-ICSI- IVF-ET were effective methods to treat infertile men with CBAVD.
出处
《中国男科学杂志》
CAS
CSCD
2006年第4期52-56,共5页
Chinese Journal of Andrology
