不同生精功能和取精方式对无精子症ICSI妊娠结局的影响  

Outcomes of azoospermia with different spermatogenesis ability treated by intracytoplasmic injection with sperm from epididymis and testis

作　　者：冼志勇[1] 李飞[1] 邹亚光[2] 郭文彬[1] 李建明[3] 毛向明[1] 谭万龙[1] 郑少斌[1] 

机构地区：[1]南方医科大学南方医院泌尿外科,广州510515 [2]南方医科大学南方医院口腔科 [3]南方医科大学南方医院病理科

出　　处：《中国男科学杂志》2010年第2期35-38,共4页Chinese Journal of Andrology

基　　金：国家自然科学基金资助项目(No.30772167);广州市科技计划项目(2008J1-C131)

摘　　要：目的分析采用经皮附睾精子抽吸术(PESA)或经皮睾丸精子抽吸术(TESA)获得精子对不同生精功能无精子症进行卵泡浆内单精子注射(ICSI)治疗的妊娠结局。方法经PESA获得附睾精子,经TESA获得睾丸精子,女方进行常规超排卵。两种取精方法获得的精子进行ICSI,比较其妊娠率。结果 216次采用PESA获得附睾精子,87次采用TESA获得睾丸精子,PESA和TESA组的妊娠率分别为41.7%和43.7%,(P>0.05)。随着生精功能状态从正常到重度生精功能障碍的变化,其妊娠率依次为:46.8%,41.6%,36.7%和16.7%。其中生精功能正常组与轻度和中度生精功能障碍组差异无统计学意义,但与重度生精功能障碍组差异均有统计学意义。结论采用PESA或TESA结合ICSI是治疗男性无精子症的有效方法,而且认为生精功能正常组和轻度及中度生精功能障碍三组无精子症患者均可试行ICSI。Objiective To analyze the outcomes of azoospemia patient with different spermatogenesis ability treated by intracytoplasmic injection with sperm from epididymis and testis. Methods Sperm retrieval were from epididymis by PESA and from testis by TESA, then the patients received ICSI for treatment of infertility. The rate of pregnancy was analyzed. Results The rates of pregnancy in PESA group and TESA group were 41.7% and 43.7% respectively （P〉 0.05）. According to spermatogenesis ability, the rates of pregnancy were changed as follows： 48.9%, 40.6%, 34.0% and 14.3%. There were no significant differences in the rate of pregnancy among the normal groups, the mild group with spermatogenic dysfunction and the moderate group with spermatogenic dysfunction, but significant difference between the severe group with spermatogenic dysfunction and other groups. Conclusion The combination of ICSI with PESA or TESA might be an effective way to treat azoospermia patients with normal,mild and moderate spermatogenic dysfunction.

关 键 词：无精子症 精子注射 细胞质内 妊娠 

分 类 号：R698.2[医药卫生—泌尿科学]