基于案例探讨男性终末期肾病患者的不育问题及助孕伦理对策  

Assisted reproductive technology for male patients with end-stage renal disease: A case-based discussion on strategies and ethical issues

作　　者：刘皎婧 盛连兵 刘晓辉[2] 陶国振 范媛媛 雷丽君 柳松 杨慧军 LIU Jiao-jing;SHENG Lian-bing;LIU Xiao-hui;TAO Guo-zhen;FAN Yuan-yuan;LEI Li-jun;LIU Song;YANG Hui-jun(Center of Reproductive Medicine/Key Laboratory of Birth Regulation and Control Technology of the Health Commission of China/Key Laboratory of Eugenic Technology of Shandong Province,Maternity and Child Healthcare Hospital of Shandong Province,Jinan,Shandong 250021,China;Department of Urology,Huantai People's Hospital,Zibo,Shandong 256400,China)

机构地区：[1]山东省妇幼保健院生殖医学中心/国家卫生健康委员会生育调控技术重点实验室/山东省优生技术重点实验室,山东济南250021 [2]桓台县人民医院泌尿外科,山东淄博256400

出　　处：《中华男科学杂志》2019年第11期1011-1014,共4页National Journal of Andrology

基　　金：山东省自然科学基金培养基金(ZR2019PH085);山东省医药卫生科技发展计划项目面上项目(2018WS317);山东省医药卫生科技发展计划项目面上项目(2018WS316)~~

摘　　要：目的:通过对1例男性终末期肾病(ESRD)患者实施助孕技术的具体诊疗过程和文献复习,探讨如何在伦理指导监督下为男性ESRD患者提供规范合理的助孕治疗。方法:从1例男性ESRD患者通过ICSI助孕治疗并成功分娩的案例出发,结合流行病学分析和疾病相关文献复习,分析和探讨为男性ESRD患者实施助孕的可行性、伦理问题及策略。结果:ESRD影响男性激素水平、精子质量和勃起功能,ESRD患者的生育权与其疾病转归的不确定性、子代及女方身心健康之间存在矛盾,在充分知情告知的前提下,需全面评估患者身心状况,保障子代安全,并提请生殖医学伦理委员会审议。结论:ESRD患者的生育权、助孕选择权等应得到重视,在辅助生殖技术实施过程中,应客观、严谨的评估患者的身体状况,遵循辅助生殖技术的伦理指导原则,有利、有理、有据的帮助患者解决生育问题。Objective:To explore normalized and reasonable strategies of assisted reproductive technology(ART)for patients with end-stage renal disease(ESRD)under ethical supervision based on the experience with a case of ART for an ESRD male.Methods:A male patient with ESRD successfully fathered a child through in vitro intracytoplasmic sperm injection(ICSI)in our center.We performed an epidemiological analysis,reviewed the relevant literature and explored the feasibility,ethical issues and strategies of ART for male patients with ESRD.Results:ESRD affected the reproductive hormone levels,sperm quality and erectile function of the patient.Considering the contradictions between the reproductive right and the uncertainty of disease prognosis of the patient and the health of the offspring and his wife,we comprehensively evaluated the physical and mental conditions of the patient,obtained the informed consent,submitted the case to the Ethics Committee of Reproductive Medicine.Conclusion:With respect to ART for ESRD patients,importance should be attached to their rights of reproduction and choice of reproductive technology.In the process of ART,the physical conditions of the patient ought to be evaluated comprehensively and rigorously,and the related ethical principles followed strictly.

关 键 词：辅助生殖技术 男性终末期肾病 伦理 

分 类 号：R692.5[医药卫生—泌尿科学] R-025[医药卫生—外科学]