卵子玻璃化冷冻在睾丸取精失败周期中的临床应用(附8例报告)  

Clinical application of oocyte vitrification in failed testicular sperm extraction cycles:Report of 8 cases

作　　者：宋文妍[1] 孙莹璞[1] 金海霞[1] 辛志敏[1] 苏迎春[1] 郭艺红[1] 陈子江[2] 

机构地区：[1]郑州大学第一附属医院生殖医学中心,河南郑州450052 [2]山东省立医院生殖中心,济南山东250000

出　　处：《中华男科学杂志》2010年第4期305-309,共5页National Journal of Andrology

基　　金：国家863项目子课题基金资助(2006AA02Z4A4)~~

摘　　要：目的:探讨卵子玻璃化冷冻在睾丸取精失败周期中的临床应用价值。方法:回顾分析体外受精周期取卵日因男方无精子症行睾丸取精失败且无供精接受卵子冷冻的8例不孕症妇女。所有卵子经玻璃化冷冻保存2个月后解冻,存活的成熟卵子采用与其丈夫血型一致的精子库冷冻精子行卵细胞胞质内单精子注射(ICSI)受精,记录卵子的存活、受精、卵裂、优质胚胎、临床妊娠及分娩情况。结果:冷冻-解冻60枚卵子中存活47枚,存活率为78.3%(47/60);其中41枚成熟卵子行ICSI受精,正常受精率为80.5%(33/41),卵裂率为81.8%(27/33),优质胚胎率为59.3%(16/27);15枚胚胎移植给8例患者,移植周期率为100%(8/8),平均移植胚胎数为1.9±0.8。B超显示有5个孕囊形成,胚胎种植率为33.3%(5/15);5例患者获得了临床妊娠,临床妊娠率为62.5%(5/8),均为宫内单活胎。4例已顺利分娩3男婴1女婴,体重为(3 787.5±513.7)g,染色体及发育均正常。结论:卵子玻璃化冷冻是睾丸取精失败患者的有效保障,与精子库冷冻供精受精可以获得理想临床结局。Objective：To evaluate the clinical application value of oocyte vitrification in failed testicular sperm extraction cycles in non-obstructive azoospermia（NOA） patients.Methods：We retrospectively analyzed the clinical data of 8 women undergoing oocyte frozen-thawing cycles by vitrification because of failed testicular sperm extraction from their NOA husbands and no banked donor sperm on the day of oocyte retrieval.The oocytes were cryopreserved by vitrification with cryotop and thawed 2 months later.The surviving metaphase II（MII） oocytes were injected with the banked donor sperm of the same blood type as the husbands＇ by intracytoplasmic sperm injection（ICSI） for fertilization.The rates of oocyte survival,fertilization,cleavage,good embryos and pregnancy were evaluated.Results：Sixty oocytes were vitrified and 47（78.3%） survived after thawing,of which 41 MII oocytes underwent ICSI and 33（80.5%） of them were fertilized.The rates of cleavage and good embryos were 81.8%（27/33） and 59.3%（16/27） respectively.Fifteen of the embryos were transferred to the 8 patients,with 1.9 ± 0.8 per cycle,of which 5（33.3%） were confirmed by ultrasound to have been implanted and 5 resulted in clinical pregnancy（62.5%）,all singleton without miscarriage.Three normal boys and 1 normal girl were already born,with the pregnancy time of（39＋4 ± 0.4） wk and newborn body weight of（3787.5 ± 513.7） g,respectively.Conclusion：Vitrification of oocytes in failed testicular sperm extraction cycles is a promising technique for preserving female fertility,which,with ICSI of banked donor sperm,may result in satisfactory clinical outcomes.

关 键 词：玻璃化冷冻 卵子 非梗阻性无精子症 睾丸取精术 精子库 

分 类 号：R714.8[医药卫生—妇产科学]