睾丸显微取精术联合卵胞浆内单精子显微注射治疗非梗阻性无精子症的临床效果  

Clinical effect of microdissection testicular sperm extraction combined with intracytoplasmic sperm injection in treatment of non-obstructive azoospermia

作　　者：甘贤优[1] 零潇宾 舒金辉[1] 周红[1] 杨嫚 GAN Xian-you;LING Xiao-bin;SHU Jin-hui;ZHOU Hong;YANG Man(Center of Reproductive Medicine,the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院生殖中心

出　　处：《广西医学》2019年第16期2055-2058,共4页Guangxi Medical Journal

摘　　要：目的 观察睾丸显微取精术(MD-TESE)联合卵胞浆内单精子显微注射治疗非梗阻性无精子症(NOA)的临床效果。方法 30例NOA患者均施行MD-TESE术,分析获得精子组患者与非获得精子组患者的年龄、病因、睾丸体积、促卵泡激素、黄体生成素、睾酮水平的差异。获得精子患者行卵胞浆内单精子显微注射(ICSI)助孕,分析其受精率、优胚率和临床妊娠结局。结果 30例患者行MD-TESE术后有13例患者获得精子,获精率为43.3%;获精组与非获精组患者的年龄、睾丸体积、促卵泡激素、黄体生成素、睾酮水平比较均无差异(均P>0.05);有10对夫妇实施ICSI助孕,受精率为(74.8±15.7)%,优质胚率为(41.2±17.5)%,临床妊娠率为70.0%(7/10),其中有4例足月分娩5名健康婴儿,3例自然流产。结论 MD-TESE术能确定NOA患者睾丸内是否存在精子,获精率较高,其与ICSI联合治疗可获得较高的临床妊娠率。Objective To observe the clinical effect of microdissection testicular sperm extraction(MD-TESE) combined with intracytoplasmic sperm injection(ICSI) in the treatment of non-obstructive azoospermia(NOA).Methods Thirty patients with NOA all underwent MD-TESE,the differences of indicators between patients in the positive sperm retrieval group and patient in the negative sperm retrieval group were analyzed,including age,etiology,testis volume,and the levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH) and testosterone.ICSI assisted reproductive therapy was performed in patients with positive sperm retrieval,and their fertilization rate,high-quality embryo rate and clinical pregnancy outcome were analyzed.Results Thirteen out of 30 patients undergoing MD-TESE obtained sperm,with a sperm retrieval rate of 43.3%;there were no statistically significant differences in age,testis volume,or level of FSH,LH or testosterone between the positive sperm retrieval group and the negative sperm retrieval group(all P>0.05);ten couples received ICSI assisted reproductive therapy,the fertilization rate was 74.8±15.7%,the high-quality embryo rate was 41.2±17.5%,and the clinical pregnancy rate was 70.0%(7/10),4 cases delivered 5 healthy babies and 3 cases had spontaneous abortion.Conclusion MD-TESE can help NOA patients to determine whether there are sperms in testis or not,with a higher sperm retrieval rate,and can get a higher clinical pregnancy rate in combination with ICSI.

关 键 词：非梗阻性无精子症 睾丸显微取精术 卵胞浆内单精子显微注射 获精率 临床妊娠率 

分 类 号：R699.8[医药卫生—泌尿科学]