PESA和TESA精子及冻融后对ICSI助孕结局的影响  

Influence of PESA/TESA and freezing-thawing of sperm on the clinical outcomes of ICSI

作　　者：余柯达[1] 陈晓[1] 杨丽华[1] 毛佳婷 邹立波[1] 师帅[1] 刘鸿[1] Yu Keda;Chen Xiao;Yang Lihua;Mao Jiating;Zou Libo;Shi Shuai;Liu Hong(Center of Reproductive Medicine,Jinhua People's Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市人民医院生殖医学中心

出　　处：《中国男科学杂志》2019年第5期24-27,共4页Chinese Journal of Andrology

基　　金：国家自然科学基金资助项目（81702401)

摘　　要：目的探讨不同来源[经皮附睾精子抽吸术(PESA)和睾丸精子抽吸术(TESA)]精子以及冻融后的PESA和TESA精子对ICSI助孕结局的影响。方法回顾性分析了在本院生殖中心接受采用PESA和TESA精子行ICSI治疗的312个周期,按精子来源分为:新鲜PESA精子组(P组)117周期,新鲜TESA精子组(T组)66周期,冻融PESA精子组(FP组)85周期,冻融TESA精子组(FT组)44周期,比较各组ICSI后的胚胎发育和妊娠结局。结果P组与T组之间的卵裂率、有效胚胎率、优质胚胎率、胚胎种植率、临床妊娠率、早期流产率、多胎妊娠率和异位妊娠率差异无统计学意义(P>0.05),而P组的受精率极显著的高于T组(P<0.01),冻融后的FP组和FT组之间也具有上述同样的结果。冻融后的FP组和FT组对ICSI结局中的受精率、卵裂率和临床妊娠率等无影响(P>0.05)。结论PESA/TESA-ICSI是治疗无精子症的安全有效的方法,冻融后的PESA和TESA精子不会影响胚胎质量和妊娠结局,建议首先选择附睾精子,并对ICSI或活检后剩余的PESA和TESA精子进行冻存。Objective To investigate the effect of different sperm collection methods(percutaneous epididymal sperm aspiration/testicular sperm aspiration,PESA/TESA)and freezing-thawing on the clinical outcomes of intracytoplasmic sperm injection(ICSI).Methods A retrospective study was carried out on 312 ICSI treatment cycles adopting PESA/TESA sperm in the reproductive center of our hospital.Patients were divided into four groups according to the source of sperm:fresh PESA group(group P,H7 cycles),fresh TESA group(group T,66 cycles),frozen-thawed PESA sperm group(group FP,85 cycles)and frozen-thawed TESA sperm group(group FT,44 cycles).The outcomes of embryonic development and pregnancy were comparatively analyzed among these groups.Results There were no significant differences in the rate of cleavage,available embryo,good-quality embryo,embryo implantation,clinical pregnancy,early miscarriage,multiple pregnancy and ectopic pregnancy between group P and group T(P>0.05).But the fertilization rate in group P was significantly higher than that in group T(P<0.01).The similar results were also found between group FP and group FT.The freezing-thawing of PESA/TESA sperm(in group FP/FT)had no influence on the rate of fertilization,cleavage and clinical pregnancy of the ICSI outcomes(P>0.05).Conclusion PESA/TESA-ICSI is safe and effective method for treatment of azoospermatism.The freezing-thawing of PESA/TESA sperms have no impacts on the embryo quality and pregnancy outcomes.It is suggested to choose epididymal sperm preferentially and cryopreserve the remaining PESA/TESA sperm after ICSI or biopsy.

关 键 词：取精术 精液保存 精子注射 细胞质内 妊娠结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]