摘要
目的:回顾性分析123例无精子症患者经皮附睾精子抽吸术(PESA)或经皮睾丸精子抽吸术(TESA)后冻融复苏微量精子行卵细胞胞质内单精子注射术(ICSI)的疗效及临床妊娠结局情况。方法:将采用微量冻融PESA、TESA精子行ICSI的病例归为冻融精子组,采用新鲜PESA、TESA精子行ICSI的病例归为对照组。比较冻融精子组与新鲜精子组组间及组内的双原核(2PN)受精率、优质胚胎率、临床妊娠率、流产率、宫外孕率、多胎妊娠率有无统计学差异。结果:PESA精子冻融组与新鲜组受精率、优质胚胎率、临床妊娠率、流产率、宫外孕率及多胎妊娠率分别为75.67%vs76.49%,64.96%vs66.19%,55.21%vs57.22%,13.21%vs12.61%,3.77%vs5.41%,37.74%vs37.84%(P>0.05),TESA精子冻融组与新鲜组受精率、优质胚胎率、临床妊娠率、流产率、宫外孕率及多胎妊娠率分别为74.41%vs76.43%,64.63%vs66.35%,46.81%vs53.39%,18.18%vs14.55%,4.55%vs1.82%,37.74%vs37.84%,组间及组内均无统计学差异(P>0.05)。PESA精子与TESA精子冻融复苏成功率为70.07%vs62.67%,无统计学差异(P>0.05)。结论:微量PESA及TESA精子冻融技术对无精子症患者来说是一种安全、经济、有效的治疗方法;精子冷冻复苏技术有待于进一步提高;该技术是否会增加子代远期遗传风险仍有待于进一步探讨和研究。
Objective：To investigate the effects and clinical pregnancy outcomes of intracytoplasmic sperm insemination（ICSI） with microamount frozen-thawed sperm obtained by percutaneous epididymal sperm aspiration（PESA） or testicular sperm aspiration（TESA） in azoospermia patients.Methods：We divided 365 azoospermia patients treated by ICSI into an experimental group（n = 123） and a control group（n = 242）,the former with microamount frozen-thawed sperm,and the latter fresh sperm obtained by PESA or TESA.The rates of fertilization,good embryos,clinical pregnancy,miscarriage,ectopic pregnancy and multiple pregnancy were analyzed and compared between the two groups.Results：With PESA,the experimental group showed no statistically significant differences from the control group in the rates of fertilization（75.67% vs 76.49%）,good embryos（64.96% vs 66.09%）,clinical pregnancy（55.21% vs 57.22%）,clinical miscarriage（13.21% vs 12.61%）,ectopic pregnancy（3.77% vs 5.41%） and multiple pregnancy（37.74% vs 37.84%）（P〈0.05）;nor with TESA（74.41% vs 76.43%,64.63% vs 66.35%,46.81% vs 53.39%,18.18% vs 14.55%,4.55% vs 1.82%,37.74% vs 37.84%,P〈0.05）.The revival rate of the frozen-thawed sperm from PESA was 70.07%,not significantly different from that of TESA（62.67%）（P〈0.05）.Conclusion：ICSI with frozen-thawed micro-amount sperm obtained by PESA or TESA is a safe,economic and effective method for the treatment of azoospermia.The techniques for reviving frozen sperm from PESA or TESA remain to be optimized,and whether these techniques may result in long-term genetic risks in the offspring deserves further investigation.
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2010年第4期328-332,共5页
National Journal of Andrology
关键词
微量精子冻融
无精子症
经皮附睾精子抽吸术
经皮睾丸精子抽吸术
卵细胞胞质内单精子注射
microamount frozen-thawed perm
percutaneous epididymal sperm aspiration
testicular sperm extraction
azoospermia
intracytoplasmic sperm insemination
