14例阻塞性无精子症冻精、冻胚助孕结局分析  

Pregnant Outcomes of Cryopreserved Sperm and Embryos in 14 Obstructive Azoospermia Patients

作　　者：赵君利[1,2,3] 徐仙[1,2,3] 景万红[1,2,3] 胡蓉[1,2,3] 吴昕[1,2,3] 刘春莲[1,2,3] 哈灵侠[1,2,3] 马小红[1,2,3] 

机构地区：[1]宁夏医科大学总医院 [2]宁夏医科大学生殖与遗传重点实验室 [3]宁夏医科大学生育力保持省部共建教育部重点实验室,银川750004

出　　处：《宁夏医科大学学报》2012年第6期576-580,共5页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金项目(NZ0797;NZ11267)

摘　　要：目的探讨阻塞性无精子症助孕结局及生育力保存的有效策略和方法。方法回顾性分析2009年1月-2010年9月在我院生殖医学中心采用附睾鲜精、冻精ICSI助孕的14例阻塞性无精子症患者鲜胚及冻胚助孕结局。结果附睾精子助孕14周期,鲜胚移植12周期,冻胚移植6个周期,周期总临床妊娠率66.67%(12/18)显著高于本中心同期2009-2010年全部IVF/ICSI周期平均妊娠率38.7%～47.1%。患者可移植胚胎数、冷冻胚数及总累计妊娠率均显著高于同期严重少弱精子症组(t=2.30,P=0.034;t=2.48,P=0.025;χ2=4.49,P=0.034)。附睾鲜精组可移植胚胎数、冷冻胚数高于冻精组(t=3.03,2.56;P=0.01、0.025),但冻精组冻胚妊娠率高于鲜精相应周期。阻塞性无精子症患者组冻胚可移植率高于严重少弱精子症组(P=0.09),其冻胚移植妊娠率也高于严重少弱精子症组(P=0.011)及本中心同期全部冻胚移植平均妊娠率40%。结论阻塞性无精子症患者附睾冻精、鲜精ICSI助孕结局显著优于重度少弱精子症;冻精、冻胚是阻塞性无精子症有效的生育力保存方法;冻胚移植是鲜胚移植未孕的有效补充手段。精子、胚胎冻存可能在一定程度上有选择优良精子、胚胎的功能。Objective To determine the efficient fecundity preservation method and strategy for patients with azoospermia. Methods During 2009,Ja. -2010, Sep. , fourteen patients underwent 14 fresh IC$I cycles and 6 freezing embryo transfer cycles using fresh and eryopreserved retrieved epididymal spermatozoa. Pregnancy rates and other ICSI outcomes was retrospectively analyzed and compared with all IVF/ICSI patients and 11 patients with severe oligoasthenozoospermia during that time. Results Fourteen obstructive azoospermia patients undergone fourteen ICSI cycles with six fresh sperm cycles and 8 cryopreserved sperm cycles; 12 fresh embryo transfer and 6 freezing embryo transfer cycles were performed. The pregnancy rate was higher in azoospermia patients than that in severe oligozoospermia and whole patients group. The number of embryo, number of freezing embryo and cumulated pregnancy rate were higher in obstructive azoospermia than those in severe oligozoospermia. The pregnancy rate was higher in fresh embryo transfer cycles with cryopreserved sperm and freezing embryo transfer cycles than that in fresh embryo transfer cycles with fresh sperm and 6 freezing embryo transfer cycles. Conclusion This study showed that cryopreservation epididymal spermatozoa in obstructive azoospermia retained their higher fecundity than that in severe oligoasthenozoospermia. Sperm and embryo cryopreservation are complementary method for male fertility preservation in patients with obstruc- tive azoospermia. Cryopreservation may play a role on selecting the good quality sperm and embryo for high pregnancy rates, especially for epididymal spermatozoa.

关 键 词：阻塞性无精子症 附睾穿刺 精液 胚胎 冻存 

分 类 号：R698.2[医药卫生—泌尿科学]