微创取精术结合ICSI治疗阻塞性无精子症的研究  

The study of microtraumatic sperm retrieval and intracytoplasmic sperm injection for the obstructive azoospermia

作　　者：王嵩[1] 李晓红[1] 武学清[1] 张晓[1] 陈菲[1] 郭应禄[1] 

机构地区：[1]北京大学第一医院生殖与遗传医疗中心,北京100034

出　　处：《中国男科学杂志》2006年第4期29-31,共3页Chinese Journal of Andrology

摘　　要：目的探讨采用微创手术从阻塞性无精子症患者获取精子,再行卵母细胞单精子显微注射(ICSI)及胚胎移植治疗不育症的效果。方法对20例阻塞性无精子症患者先行经皮附睾精子抽吸术(PESA),如果未取到精子,再行睾丸精子穿刺吸取术(TESA),随后行ICSI辅助生育治疗周期共20次。结果20例病人中,采用PESA成功获得精子者共18例,未成功者2例,进一步行TESA后,均获得精子。用取得的精子行MⅡ期卵子ICSI后,受精率达68．09%,在20例胚胎移植后获得临床妊娠9例(45%)。结论对于阻塞性无精子症患者,应用微创取精术可以成功获得精子,行ICSI治疗后可获得满意的受精率和临床妊娠率,微创取精术可以成为阻塞性无精子症患者获得精子的首选方法。Objective To evaluate the result of the microtraumatic sperm retrieval and intracytoplasmic sperm injection （ICSI） from obstructive azoospermic （OA） men. Methods Sperm retrieval was accomplished at first by percutaneous epididymal sperm aspiration （PESA） in 20 OA men. Testicular sperm aspiration （TESA） was only applied when PESA failed to get spermatozoa for ICSI. Then the spermatozoa retrieved were used in the followed 20 in-vitro fertilization cycle using ICSI. Results Percutaneous epididymal sperm aspirations （PESA） were successfully applied in 18 cases and testicular sperm aspiration（TESA） in 2 cases. Fertilization rate by ICSI was 68.09% of the metaphase Ⅱ oocytes. 20 embryo＇transfers were performed and 9 cases of clinical pregnancy were obtained. Conclusion Microtraumatic sperm retrieval with ICSI is able to gain a high fertilization and pregnant rate for obstructive azoospermic men. Microtraumatic sperm retrieval should be the initial sperm retrieval method for patients with obstructive azoospermia.

关 键 词：外科手术 微创性 精子注射 胞浆内 少精子症 

分 类 号：R698.2[医药卫生—泌尿科学]