附睾和睾丸冷冻精子行卵胞浆内单精子注射临床效果的分析  

Analysis on Clinical Effects of ICSI with Frozen-thawed Epididymal and Testicular Sperm

作　　者：于洪君[1] 王秀霞[2] 许蓬[1] 孙晓玲[1] 程东凯[1] 刘吉[1] 李宝山[1] 

机构地区：[1]沈阳东方医疗集团菁华医院生殖中心生殖实验室,110005 [2]中国医大附属盛京医院妇产科生殖中心,110003

出　　处：《中国中医药现代远程教育》2010年第16期104-106,共3页Chinese Medicine Modern Distance Education of China

摘　　要：目的探讨诊断性附睾、睾丸活检后冷冻精子行卵胞浆内单精子注射（ICSI）能否获得与新鲜附睾、睾丸行ICSI相近的临床治疗效果。方法回顾性分析无精患者行ICSI治疗201个周期,其中门诊诊断性附睾、睾丸活检后冷冻复苏精子为冻精组（21个周期）,取卵日采用新鲜附睾或睾丸精子为对照组（180个周期）。评估两组的受精率、胚胎质量、妊娠率和种植率。结果冻精组、对照组分别注射成熟MⅡ期卵子245、1896个,冻精组的受精率、卵裂率和优胚率分别为（79.8±20.7）%、（96.7±8.88）%、（61.2±26.8）%;对照组分别为（81.9±15.8）%、（97.1±11.3）%、（49.4±29.5）%,两组间均无显著性差异（P〉0.05）。冻精组共妊娠8例,宫外孕1例。对照组共妊娠67例,流产13例,1例引产（妊娠28周时诊断为多囊肾）。冻精组临床妊娠率和胚胎种植率分别为40.0%、27.3%;对照组分别为38.3%、25.4%,亦无统计学差异（P〉0.05）。结论无精子症患者实施诊断性附睾及睾丸活检获取精子并冷冻用于ICSI的临床治疗是可行和有效的,可获得与新鲜附睾和睾丸精子ICSI相近的临床结果。Objective To discuss whether diagnostic epididymal and testicular biopsy followed by cryopreservation for intracytoplasmic sperm injection（ICSI）was feasible to clinical treatment as fresh epididymal and testicular sperm for ICSI.Methods This retrospective study involved 201 treatment cycles of patients with obstructive azzoospermia.Cryopreservated group（21 cycles）scheduled with frozen-thawed epididymal and testicular sperm from diagnostic epididymal and testicular biopsy.Control group（180 cycles）scheduled with fresh epididymal and testicular sperm at the day of oocyte retrieval.Fertilization,embryo quality,pregnancy and implantation rates were evaluated.Results 245、1896 matural MⅡ oocytes were used for ICSI in cryopreservated group and control group respectively.Fertilization rate,cleavage rate and high qualitied embryo rate in cryopreservated group were in turn（79.8±20.7）%、（96.7±8.88）%、（61.2±26.8）%,in control group were in turn（81.9±15.8）%、（97.1±11.3）%、（49.4±29.5）%.There was no significant difference between the two groups（P0.05）.In the cryopreservated group,8 clinical pregnancies were achieved including 1 ectopic pregnancy.In the control group,67clinical pregnancies were achieved including 13 miscarriages.Clinical pregnancy rate and implantation rate observed in cryopreservated group were 40.0%、27.3%,in control group were 38.3%、25.4%,respectively..The differences between the two groups were of no statistical significance（P 0.05）.Conclusions Our results indicated that diagnostic epididyman and testicular biopsy followed by cryopreservation for ICSI was feasible and efficient for patients with azoospermia.The clinical outcomes were similar to that of ICSI with fresh epididymal and testicular sperm.

关 键 词：睾丸活检 无精子症 冷冻 卵胞浆内单精子注射 妊娠 

分 类 号：R698.2[医药卫生—泌尿科学]