66例男性不育患者采用自然周期IVF/M结合胞浆内单精子注射技术治疗的研究  

Combination of natural cycle IVF/M with intracytoplasmic injection of epididymal,testicular and ejaculated sperm for treatment of male infertility with azoospermia and oligozoospermia

作　　者：徐野[1] 李建华[1] 秦似龙[1] 周国萍[1] 郭军红[1] 

机构地区：[1]北京军区总医院生殖医学中心,北京100700

出　　处：《中国男科学杂志》2008年第12期47-51,共5页Chinese Journal of Andrology

摘　　要：目的探讨自然周期成熟卵母细胞结合未成熟卵母细胞体外成熟方法(natural cycle in vitro fertilization combined with in vitro maturation of immature oocytes,自然周期IVF/M)用于治疗男性因素引起不育的临床价值。方法66例适应证患者分成3组:少弱精子组、偶见活精子组和无精子症组[行经皮附睾精子抽吸术(PESA)、睾丸精子抽吸术(TESA)或睾丸切开取精术(TESE)],接受72个自然周期IVF/M,比较三组受精率和临床妊娠率。结果64例患者完成70个治疗周期。少弱精子组、偶见活精子组和无精子症组分别占完成周期数的54.3%、38.6%和7.1%,共获得卵母细胞812个,平均(11.3±5.2)个。卵母细胞成熟率为61.2%,正常受精率为82.2%,卵裂率为90.0%(377/419)。共26例患者获得临床妊娠,每取卵周期的妊娠率为36.4%(26/72),每移植周期的妊娠率为37.1%(26/70)。三组受精率分别为84.5%、78.9%和80.0%,三组间差异无统计学意义(P>0.05),临床妊娠率分别为39.5%,29.6%和60.0%,PESA/PESE和TESE组的临床妊娠率(60%)显著高于精液中偶见活精子组(29.6%,P<0.05)。结论自然周期IVF/ M技术对于治疗由于男性因素引起的不育如少弱精子症以及无精子症是一种简便有效的方法。Objective To evaluate the clinical efficiency of natural cycle in vitro fertilization and in vitro maturation of immature oocytes （natural cycle IVF/M） combined with intracytoplasmic injection （ICSI） for treatment of male infertility with oligozoospermia and azoospermia. Methods Total of 66 women with normal ovaries underwent 72 treatment cycles. The rates of fertilization and pregnancy were comparatively analyzed among three groups including （1） oligozoospermia in the ejaculation; （2） occasionally live sperm in the ejaculation; （3） azoospermia males with sperm obtained from percutaneous epididymal sperm aspiration （PESA）, testicular sperm aspiration （TESA） or testicular sperm extraction （TESE）. Results Sixty-four patients completed 70 treatment cycles. A total of 812 oocytes were obtained with an average of 11.3＋5.2. The maturation rate, fertili- zation rate and cleavage rate of oocytes were 61.2%, 82.2% and 90.0% respectively. Total of 26 patients had clinically pregnant with 37.1% pregnancy rate per Iransfer. There was no significant difference in fertilization rate （84.5%, 78.9% and 80.0%） among three groups （P〉 0.05）. The clinical pregnancy rate in three groups were 39.5%, 29.6% and 60.0%, respectively. Surprisingly, the clinical pregnancy rate in group of sperm by PESA, TESA and TESE （60%） was significantly higher than that in group of sperm occasionally seen in the ejaculation （29.6%, P〈 0.05）, Conclusion Combination of natural cycle IVF/ M with ICSI of epididymal, testicular sperm （by PESA and TESE） and ejaculated sperm is an efficient method for treatment of male infertility with azoospermia and oligozoospermia.

关 键 词：月经周期 受精 体外 不育 男性 精子注射 细胞质内 

分 类 号：R698.2[医药卫生—泌尿科学]