非梗阻性无精子症患者采用睾丸显微取精术联合睾丸组织混悬液冷冻的临床效果  

Clinical evaluation of micro-testicular sperm extraction combined with testicular tissue suspensions cryopreservation in the treatment of non-obstructive azoospermia

作　　者：安庚[1] 付欣[1] 康祥锦[1] 郭飞翔 杜红姿[1] 刘见桥[1] 张文[1] An Geng;Fu Xin;Kang Xiangjin;Guo Feixiang;Du Hongzi;Liu Jianqiao;Zhang Wen(Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院生殖医学中心,510150

出　　处：《中华生殖与避孕杂志》2018年第9期730-733,共4页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金青年项目资助(81401191)~~

摘　　要：目的探讨睾丸显微取精术(micro-TESE)联合睾丸组织混悬液冷冻治疗不同病理类型的非梗阻性无精子症(non-obstructive azoospermia,NOA)行卵胞质内单精子显微注射(intracytoplasmic sperm injection,ICSI)的临床结局。方法回顾性分析2016年3月—2017年3月期间本中心经MicroTESE手术获取精子并进行睾丸组织混悬液冷冻的NOA患者的ICSI结局。结果 70例NOA患者中,micro-TESE获得精子30例(42.9%)。睾丸生精细胞成熟阻滞者(maturation arrest,MA)的获精率(sperm retrieval rate,SRR)显著低于生精功能低下者(hypo-spermatogenesis,H-S),差异有统计学意义(P=0.00),但同唯支持细胞综合征(Sertoli cell only syndrome,SCOS)比较,差异无统计学意义(P=0.64)。而早期睾丸生精细胞成熟阻滞(early MA)的SRR[20.8%(5/24)]低于晚期生精细胞成熟阻滞(late MA)[43.8%(7/16)]。30例睾丸组织混悬液解冻行ICSI注射,临床妊娠率为46.7%(14/30)。其中,MA组临床妊娠率为41.7%(5/12);H-S组临床妊娠率为47.1%(8/17);SCOS组1例行ICSI后临床妊娠。结论在辅助生殖技术中,睾丸显微取精术联合睾丸组织混悬液冷冻治疗NOA患者,临床结果满意。Objective To investigate the intracytoplasmic sperm injection（ICSI） outcome of testicular tissue suspensions cryopreservation combined with micro-testicular sperm extraction（TESE） in the treatment of non-obstructive azoospermia（NOA） with different pathological types. Methods We retrospectively analyzed the ICSI outcome of NOA patients undergoing micro-TESE and testicular tissue suspensions cryopreservation from March 2016 to March 2017. Results In 70 cases of NOA, spermatozoa of 30 cases（42.9%） were obtained from micro-TESE. The sperm retrieval rate（SRR） of the patients with spermatogenic cells maturation arrest was significantly lower than that of the patients with hypo-spermatogenesis（H-S）（P=0.00）. However, compared with Sertoli cell only syndrome（SCOS）, the difference was not statistically significant（P=0.64）. The SRR of early maturation arrest [20.8%（5/24）] was lower than that of late maturation arrest [43.8%（7/16）]. Thirty cases of testicular tissue thawed were injected with ICSI. The clinical pregnancy rate was 46.7%. The clinical pregnancy rate was 41.7% in maturation arrest group and 47.1% in H-S group. Conclusion In the assisted reproductive technique, the clinical results testicular of tissue suspensions freezing combined with micro-TESE for NOA patients are satisfactory, which would provide new ideas and options for clinical treatment of NOA patients.

关 键 词：睾丸显微取精术(micro-TESE) 睾丸组织混悬液冷冻 非梗阻性无精子症(NOA) 卵胞质内单精子注射(ICSI) 

分 类 号：R698.2[医药卫生—泌尿科学]