不同来源精子应用于ICSI治疗的早期临床结局  

Early Clinical Outcomes of ICSI with Sperm from Different Sources

作　　者：汤友苗 王兴玲[1] 娄华[1] 乔玉莲 杜明泽 TANG Youmiao;WANG Xingling;LOU Hua(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450052

出　　处：《中国医学创新》2018年第5期22-25,共4页Medical Innovation of China

基　　金：河南省医学科技攻关计划项目(201702110)

摘　　要：目的:比较不同来源精子应用于卵胞浆内单精子显微注射(ICSI)治疗的胚胎发育及早期临床结局。方法:回顾性分析2014年1月-2016年6月因男性因素在郑州大学第三附属医院生殖中心行ICSI治疗的1 732个新鲜移植周期。根据精子来源分为:A组射精组(n=1 253),B组经皮附睾精子抽吸(PESA)组(n=418),C组经皮睾丸精子取精(TESA)组(n=61)。比较三组正常受精率、正常卵裂率、优质胚胎率、临床妊娠率、异位妊娠率、流产率、活产率及早产率。结果:C组的正常受精率、正常卵裂率均低于A组和B组(P<0.05),B组优质胚胎率高于A组和C组(P<0.05),B组临床妊娠率高于A组(P<0.05),三组异位妊娠率、流产率、活产率及早产率比较,差异均无统计学意义(P>0.05)。结论:PESA和TESA均可以用于梗阻性无精子症患者的助孕,但就早期胚胎质量和临床妊娠率综合考虑,经皮附睾取精行卵胞浆内单精子显微注射术更优。Objective:To compare the embryonic development and early clinical outcomes of intracytoplasmic sperm injection(ICSI)with sperm from different sources.Method:The date of 1 732 cases received ICSI from January 2014 to June 2016 in Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University was analyzed retrospectively.According to the source of sperm,all cases were divided into group A(ejaculation group,n=1 253),group B[percutaneous epididymal sperm aspiration(PESA),n=418],group C[testicular sperm extraction(TESA),n=61].The embryonic development and pregnancy outcomes among three groups were compared.Result:The rate of normal fertilization and cleavage in group C were significantly lower than those in group A and group B(P<0.05).Group B had more good-quality embryo than those of group A and group C(P<0.05).The clinical pregnancy rate in group B was higher than that in group A(P<0.05).There were no significant differences in ectopic pregnancy rate,abortion rate,live birth rate and premature delivery rate among three groups(P>0.05).Conclusion:PESA and TESA can be used in patients with obstructive azoospermia.However,considering the early embryonic quality and clinical pregnancy rate,PESA-ICSI is better.

关 键 词：卵胞浆内单精子显微注射 精子来源 经皮附睾精子抽吸术 经皮睾丸精子取精术 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]