不同参数不同来源精子行ICSI治疗后临床结局及出生缺陷的初步分析  

Clinical outcomes and birth defects resulting from intracytoplasmic sperm injection using sperms of different origins and parameters

作　　者：倪运萍[1] 陈士岭[1] 王庆玲[1] 郑海燕[1] 伍芳蓉[1] 施晓鋆[1] 罗燕群[1] 夏容[1] 

机构地区：[1]南方医科大学南方医院生殖中心,广东广州510515

出　　处：《南方医科大学学报》2010年第5期957-959,共3页Journal of Southern Medical University

基　　金：国家重点基础研究发展规划课题(973课题)(2007CB948104)

摘　　要：目的通过分析比较不同参数不同来源精子行卵细胞浆内单精子注射(ICSI)治疗后其胚胎质量、临床结局和出生缺陷之间的差异性,以探讨ICSI治疗的安全性。方法对980个ICSI周期按精子参数和来源分为A(正常或轻度异常精液)、B(严重少弱精子症)、C(附睾精子)、D(睾丸精子)4组,比较其实验室及临床各部分数据,并行统计学分析。结果 4组的受精率、卵裂率及优质胚胎率无显著性差异(P>0.05);C组的胚胎着床率、临床妊娠率高于A组与B组(P<0.05);A、B、C三组出生缺陷率比较无显著性差异(P>0.05),D组未发生出生缺陷。结论不同参数、不同来源精子行ICSI治疗均能获得相似的令人满意的受精率、优质胚胎率和分娩率。附睾精子组获得的胚胎着床率与临床妊娠率较高,可能与总体年龄较轻、获卵数较多有关。Objective To explore the quality of the embryos, clinical outcomes and birth defects resulting from intracytoplasmic sperm injection （ICSI） treatment using sperms of different origins and parameters. Methods A total of 980 ICSI-ET （embryo-transfer） cycles were divided into 4 groups, namely normal sperm or mild oligozoospermia group （group A）, severe oligozoospermia group （group B）, epididymal aspirates group （group C） and testicular biopsies group （group D）. The cleavage rate, embryo quality, fertilization rate, clinical pregnancy rate, and rates of birth defects were compared between the groups. Results The fertilization rate, cleavage rate and good-quality embryo rate were not significantly different among the 4 groups （P0.05）, and the embryo implantation rate and clinical pregnancy rate were significantly higher in group C than in groups A and B （P0.05）. Groups A, B and C showed no significant differences in the rates of birth defects （P0.05）, and no birth defects occurred in group D. Conclusions Sperms of different parameters and origins used in ICSI treatment can achieve similar fertilization rate, good-quality embryo rate and delivery rate. The embryo implantation rate and clinical pregnancy rate of epididymal sperm group are higher than those of ejaculated groups, possibly due to the younger age of the patients and a greater number of oocytes retrieved in group C than in groups A and B.

关 键 词：卵细胞浆内单精子注射 受精 临床妊娠 出生缺陷 

分 类 号：R714.8[医药卫生—妇产科学]