探讨严重畸形精子症患者助孕方式的选择  

To explore the choice of assisted pregnancy in patients with severe malformation sperm

作　　者：苏占营[1] 吴成亮[1] 辜敏[1] 巢时斌[1] 张琴[2] SU Zhanying;WU Chengliang;GU Min;CHAO Shibin;ZHANG Qin(Department of assisted reproduction,Jiujiang maternal and child health hospital,Jiu Jiang,332000,China;Department of clinical laboratory,Jiujiang maternal and child health hospital,Jiu Jiang,332000,China)

机构地区：[1]九江市妇幼保健院辅助生殖科,江西九江332000 [2]九江市妇幼保健院辅助检验科,江西九江332000

出　　处：《实验与检验医学》2018年第2期153-154,164,共3页Experimental and Laboratory Medicine

基　　金：国家自然科学基金(81360106);江西省教育厅(GJJ13199)

摘　　要：目的探讨严重畸形精子症患者选择合理受精助孕方式。方法回顾性分析2014年5月-2017年5月3年来在我中心接受试管婴儿手术的39对夫妇助孕结局,其男性患者均为严重畸形精子症患者,女性患者为年龄在25岁-37岁单纯因输卵管因素导致不孕不育患者,其中21对夫妇(总共23治疗周期:其中2对夫妇治疗2周期)采用常规体外受精技术(A:常规受精组),12对(12周期)采用卵胞浆内单精子注射技术(B:单精组),6对(6周期)采取补救单精子技术(C:补救组)助孕。结果 A:常规受精组、B:单精组、C:补救组,三组2pn受精率、2pn卵裂率、优质胚胎率分别为73.75%、75.54%、72.46%;96.05%、94.29%、94.00%;48.82%、51.52%、44.68%;(P>0.05)。其中常规组临床妊娠12例,单精组妊娠5例(1例中期流产),补救组临床妊娠3例。结论单纯男性严重畸形精子症患者不是卵胞浆内单精子注射技术(ICSI)绝对适应症,谨慎运用此技术不会造成受精率降低或失败。Objective To investigate the reasonable fertilization and assisted pregnancy mode in patients with severe malformation sperm.Methods Retrospective analysis of the outcomes of 39 couples who received IVF in our center during the 3 years from May 2014 to May 2017,all the male patients were suffered from severe oligozoospermia,and the female patients were only 25 to 37 years old,which caused infertility only because of tubal factors.21 pairs of them(23 cycles:2 couples were treated for 2 cycles)were treated with conventional in vitro fertilization(A:conventional fertilization group),12 pairs of them(12 cycles)were treated with intracytoplasmic sperm injection(B:single sperm group)and 6 pairs of them(6 cycles)were treated with remedial single sperm technique(C:remedial group)to assist pregnancy.Results The 2pn fertilization rate,2pn cleavage rate and good quality embryo rate were 73.75%、75.54%、72.46%,96.05%、94.29%、94.00%,48.82%、51.52%、44.68%in the conventional fertilization group,single sperm group and remedial group,respectively(P>0.05).Among them,12 cases of clinical pregnancy in routine group,5 cases of pregnancy in single sperm group(1 cases of metaphase abortion)and 3 cases of clinical pregnancy in remedial group.Conclusion Male patients with simple severe oligozoospermia are not absolute indications for intracytoplasmic sperm injection(ICSI),and careful use of this technique will not result in reduction or failure of fertilization rate.

关 键 词：严重畸形精子症 卵胞浆内单精子注射(ICSI) 体外受精与胚胎移植(IVF-ET) 补救单精子技术(R-ICSI) 

分 类 号：R446.19[医药卫生—诊断学] R698.2[医药卫生—临床医学]