不同来源精子对卵胞浆内单精子注射治疗结局的影响  

Influence of sperm from different sources on the treatment outcome of intracytoplasmic sperm injection

作　　者：管群[1] 于艳[1] 张琪瑶[1] 于庆[1] 孔风云[1] 邹智全[1] 孙伟[1] 

机构地区：[1]山东中医药大学第二附属医院生殖科济南,250001

出　　处：《中国男科学杂志》2011年第6期22-25,共4页Chinese Journal of Andrology

基　　金：国家自然科学基金（30973790）

摘　　要：目的分析不同来源精子对卵胞浆内单精子注射（ICSI）临床结局的影响。方法接受ICSI治疗的不育夫妇共进行了286个周期，分为3组，A组（射出精子组）：射出精液少弱畸（包括严重少弱畸）精子症186个周期；B组（PESA组）：经皮附睾抽吸术（PESA）80个周期；C组（TESE组）：睾丸精子获取术（TESE）20个周期，比较其妊娠结局。结果PESA组受精率明显高于射出精子组和TESE组（88％VS84％，77％，P〈0．01），PESA组的临床妊娠率显著高于射出精子组（47％，33％，P〈0．05），射出精子组临床妊娠率高于TESE组，但差异无统计学意义；3组的种植率差异极显著（20．7％，31．4％，13．2％，P〈0．01）；卵裂率（99％，98％，98％）、流产率（7％，15％，0％）均没有显著差异。结论PESA来源精子比射出精子组及TESE组的受精率及临床妊娠率有所增高，但TESE和PESA来源精子对临床妊娠率没有影响，射出精子组和TESE组来源精子对临床妊娠率没有影响。对于重度少弱精子症患者和梗阻性无精子症患者，进行ICSI治疗，均有机会获得妊娠。Objective To investigate the clinical outcome of intracytoplasmic sperm injection （ICSI） using different sources sperm. Methods Patients were divided into three groups according to their sperm retrieval methods. Patients in group A （n=186） with sperm obtained from ejaculates, B group （n=80） with sperm obtained by percutaneous epididymal sperm aspiration （PESA） and C group （n=20） with sperm obtained by testicular sperm extraction （TESE）. Results The fertilization rate in the PESA was significantly higher than that in the ejaculate and TESE groups （88% vs 84%, 77%, P〈0.01）, and clinical pregnancy rate was significantly higher than that in the ejaculate group （47%, 33%, P〈0.05）, clinical pregnancy rate in the ejaculate group was higher than that in the TESE group, but no significant differences. There were obvious differences in the rate of implantation among three groups （20.7%, 31.4%, 13.2%, P 〈0.01）. No significant differences were found among these three groups in the rates of cleavage （99%, 98%, 98%）, abortion （7%, 15%, 0%）. Conclusion All results indicates that sperm obtained from PESA might improve the rate of fertilization and clinical pregnancy, but sperm obtained from PESA and TESE had no obvious influence on the rate of clinical pregnancy. Male infertility can be treated by ICSI using sperm from ejaculation, epididymis or testis.

关 键 词：卵细胞胞浆内单精子注射 射精 经皮附睾精子抽吸术 睾丸精子获取术 妊娠结局 

分 类 号：R698.2[医药卫生—泌尿科学]