248例无精子症临床治疗结局分析  

Outcomes of 248 cases of azoospermia by different treatment

作　　者：钟兴明[1] 韦相才[1] 陈瑞玲[1] 陆艳华[1] 姚小涛[1] 黄彩虹[1] 

机构地区：[1]广东省计划生育科学技术研究所,广州510600

出　　处：《中国男科学杂志》2008年第7期26-28,31,共4页Chinese Journal of Andrology

基　　金：广东省科技厅项目资助;编号2002C31502

摘　　要：目的探讨治疗无精子症的最佳治疗方案。方法回顾性分析2002年1月—2003年12月就诊于我院的248例无精子症患者的临床资料,其中208例接受供精人工授精(AID),8例行附睾精子抽吸术(ESA)结合卵细胞内单精子注射(ICSI),32例接受供精体外受精胚胎移植(IVF-D)。分析其临床结局和相关影响因素。结果208例接受AID患者共行624个人工授精周期,采用双次宫颈管内人工授精(ICI)或宫腔内人工授精(IUI),周期妊娠率15.22%(95/624);ESA+ICSI8例,共行12个治疗周期,妊娠率为25%(3/12);接受IVF-D患者32例,共行47个移植周期,妊娠率31.91%(15/47)。AID妊娠率低于ICSI和IVF-D(P<0.05)。多胎妊娠率AID为6.32%(6/95),显著低于ICSI[33.33%(1/3)]和IVF-D[33.33%(5/15)](P<0.05)。AID自然流产率与ICSI和IVF-D组相比无统计学差异(P>0.05)。结论AID是治疗无精子症最常用的方法,具有简便和经济等优点;阻塞性无精子症患者宁可选择ESA结合ICSI获得自己的后代;如合并其它不孕因素则可选择IVF-D提高妊娠率。Objective To summarize the clinical outcomes of azoospermia by different treatment. Methods Clinical recorders of 248 patients with azoospermia from January 2002 to December 2003 ,who received treatment in the hospital,were retrospective analyzed.Among this patients, 208 patients Were treated with artificial insemination by donor （AID）, 8 with epididymal sperm aspiration（ESA） combined with intracytoplasmic sperm injection（ICSI）, and the otherswith donor sperm in vitro fertilization and embryo transfer（IVF-D）. Results 208 cases received 624 cycles AID which treated by intracervical insemination （ICI） or intrauterine insemination （IUI）.The cycle pregnancy rate was 15.22% （95/624）; 8 cases received 12 cycles of ESA＋ICSI and the pregnancy rate was 25% （3/12）; 32 cases received 47 cycles, IVF-D and the pregnancy rate was 31.91% （15147）. The pregnancy rate of AID was lower than ESA＋ICSI and IVF-D （P〈0.05）. The multiple pregnancy rate of AID was 6.32% （6 / 95） which was significantly lower than that of ESA＋ICSI（33.33%） and IVF-D （33.33%） （P〈0.05）. However, there is no siganificant difference in the spontaneous abortion rate of AID and ESA＋ICSI, as well as IVF-D （P〉0.05）. Conclusion AID is a simple, economic and common treatment for azoospermia. Furthermoer, ESA＋ICSI or IVF-D also can be choosed for therapy of block azoospermia or other sterile women to increase the pregnancy rate.

关 键 词：少精子症/外科疗法 治疗结果 回顾性研究 

分 类 号：R698.2[医药卫生—泌尿科学]