取卵日因手淫取精失败改行手术取精及时干预对于卵胞浆内单精子注射结局的影响  

Analysis of the effect of surgical sperm retrieval in ejaculation failure on day of oocyte retrieval on pregnancy outcomes after ICSI

作　　者：高兴成[1] 胡鹏[1] 

机构地区：[1]广州医学院第三附属医院泌尿外科,510150

出　　处：《中华临床医师杂志（电子版）》2012年第13期31-34,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省科技厅科技计划项目[粤科字(2008)146号文]

摘　　要：目的使用促性腺激素探讨取卵日因手淫取精失败改行手术取精对卵胞浆内单精子注射(ICSI)结局的影响。方法回顾性分析了2007年1月至2010年7月行ICSI治疗,在取卵日因男方手淫取精失败而改行手术取精(PESA/TESA)的病例共25例,对照组选取因梗阻性无精子症行手术取精的病例共215例。比较两组ICSI治疗的受精率、卵裂率、优胚率、种植率、临床妊娠率、流产率、活产率以及畸形率。结果两组患者的基本情况:女方年龄、不孕年限、使用促性腺激素(Gn)的总量以及Gn的天数两组之间相比差异无统计学意义(P>0.05)。两组患者的妊娠情况:受精率、卵裂率、种植率、临床妊娠率、流产率、活产率两组之间相比差异无统计学意义(P>0.05)。两组患者的优胚率相比差异有统计学意义(P=0.032)。两组的畸形率均为0。结论 (1)手术日体外取精失败,改行手术取精后行ICSI妊娠结局相似,说明取卵日手淫取精失败进行PESA/TESA及时干预是一种有效的方法,可以避免错失治疗的最佳时机;(2)精神心理因素对于ICSI的妊娠结局有一定的影响,会造成受精率、卵裂率、优胚率、种植率以及临床妊娠率降低。Objective Analysis of the effect of surgical sperm retrieval in ejaculation failure on day of ooeyte retrieval on pregnancy outcomes after ICSI. Methods Retrospectively analyze 25 cases in our Center for Reproductive Medicine who had ejaculation failure on the day of oocyte retrieval and underwent surgical sperm retrieval combining with ICSI from January 2007 to July 2010. The control group had 215 cases who suffered from obstructive azoospermia. The age of the female and infertility, the amount of Gn, the using days of Gn, the rate of fertilization, the rate of cleavage, the rate of high quality embryo, the rate of embryo implantation, the pregnancy rate, the abortion rate, the one gestation rate, the two gestation rate, the premature birth rate, the live birth rate, the malformation rate were compared between 2 groups. Results The age of the female and infertility, the amount of Gn, the using days of Gn, the rate of fertilization,the rate of cleavage,the rate of embryo implantation, the pregnancy rate, the abortion rate, the live birth rate had no significant differences between the two groups （P 〉 0. 05）. The rate of high quality embryo had significant difference between them （ P = 0. 032）. The malformation rate were 0 in both groups. Conclusions （ 1 ） The treatment outcomes of ICSI with sperm retrieved by surgical sperm retrieval in ejaculation failure on day of oocyte Retrieval and obstructive azoospermia are similar. It shows that surgical sperm retrieval combining with ICSI is an effective method for these men with ejaculation failure on day of oocyte retrieval, and it can avoid missing the best time for treatment ; （2） Psychological factors can affect the treatment outcomes of ICSI, it can reduce the rate of fertilization, the rate of cleavage, the rate of high quality embryo, the rate of embryo implantation, the pregnancy rate,the abortion rate, the premature birth rate and the live birth rate.

关 键 词：精子注射 细胞质内 经皮附睾精子抽吸术 睾丸穿刺精子抽吸术 

分 类 号：R714.8[医药卫生—妇产科学]