ICSI周期显微镜下睾丸切开取精术治疗非梗阻性无精子症的临床研究  

Clinical study on nonobstructive azoospermia treated by microdissection testicular sperm extraction in ICSI cycle

作　　者：孙建华 周梁 季兴哲 张洲 师娟子 邢俊平[2] SUN Jian-hua;ZHOU Liang;JI Xing-zhe;ZHANG Zhou;SHI Juan-zi;XING Jun-ping(Center of Asisted Reproductive Technology,Northwest Women&Children’s Hospital,Xi’an 710003;Department of Urology,First Affiliated Hospitanl of Xi’an Jiaotong University,Xi’an710061)

机构地区：[1]西北妇女儿童医院生殖中心,西安710003 [2]西安交通大学第一附属医院泌尿外科,西安710061

出　　处：《生殖医学杂志》2019年第2期129-133,共5页Journal of Reproductive Medicine

基　　金：国家自然科学基金(81771657)

摘　　要：目的探讨ICSI周期显微镜下睾丸切开取精术(microTESE)治疗非梗阻性无精子症(NOA)的临床疗效。方法回顾性分析了2015年1月至2017年6月在西北妇女儿童医院生殖中心就诊、并在第一周期接受ICSI周期microTESE的281例NOA患者和ICSI周期睾丸穿刺取精术的95例梗阻性无精子症(OA)患者的临床资料,比较两组之间获取精子行ICSI的正常受精率、优胚率、临床妊娠率、流产率、活产率,以及两组间新生儿的出生参数。结果 NOA组和OA组在正常受精率(63.50%vs.66.37%)、优胚率(46.24%vs.46.35%)、临床妊娠率(60.29%vs.70.97%)、流产率(5.88%vs.4.84%)及出生婴儿活产率(54.41%vs.66.13%)方面的差异均无统计学意义(P>0.05);NOA组和OA组间出生新生儿的孕周[(38.27±1.79)周vs.(38.31±2.22)周]、出生体重[(2.98±0.62)kg vs.(2.87±0.68)kg]及男性性别比例(43.48%vs.66.00%)均无统计学差异(P>0.05)。结论 ICSI周期显微镜下睾丸切开取精术治疗非梗阻性无精子症患者婴儿的活产率偏低,但是出生新生婴儿的各种参数正常,值得临床推广。Objective:To evaluate the clinical efficacy of microdissection testicular sperm extraction(microTESE)for the patients with non-obstructive azoospermia(NOA)in ICSI cycles.Methods:The data of 281 NOA patients treated by microTESE and 95 patients with obstructive azoospermia(OA)treated by testicular sperm aspiration(TESA)in first ICSI cycles in Center of Assisted Reproductive Technology,Northwest Women and Children’s Hospital from January 2015 to June 2017 were retrospectively analyzed.The normal fertilization rate,high quality embryo rate,clinical pregnancy rate,abortion rate,live birth rate and birth parameters of newborn were compared between the two groups.Results:There were no significant differences in normal fertilization rate(63.50%vs.66.37%),the high quality embryo rate(46.24%vs.46.35%),the clinical pregnancy rate(60.29%vs.70.97%),the abortion rate(5.88%vs.4.84%),and the live birth rate(54.41%vs.66.13%)between the NOA group and OA group(P >0.05).There were also no significant differences in gestational weeks[(38.27±1.79)vs.(38.31±2.22)weeks],the birth weight[(2.98±0.62)vs.(2.87±0.68)kg]and the male sex ratio(43.48%and 66.00%)between the two groups(P >0.05).Conclusions:The live birth rate is lower in the patients with non-obstructive azoospermia treated by microdissection testicular sperm extraction in ICSI cycles,but the parameters of newborn are normal and it is worthy of clinical promotion.

关 键 词：显微镜下睾丸切开取精 无精子症 ICSI 妊娠结局 新生儿出生参数 

分 类 号：R711.6[医药卫生—妇产科学]