显微取精术在非梗阻性无精子症患者中的临床应用及结局  

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

作　　者：李建华 焦婷婷 王建业 成彦彬 李常山 张水文 LI Jian-hua;JIAO Ting-ting;WANG Jian-ye;CHENG Yan-bin;LI Chang-shan;ZHANG Shui-wen(Center of Reproductive Medicine and Genetics,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China)

机构地区：[1]中国人民解放军总医院第七医学中心生殖医学科,北京100700

出　　处：《中国优生与遗传杂志》2020年第1期107-109,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的观察睾丸显微取精术在非梗阻性无精子症患者中的临床应用及其结局。方法17例患者在配偶同步促排卵取卵前一天行睾丸显微切开取精术,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、可用胚胎率和临床妊娠结局。结果17例患者显微取精,13例成功获取精子,精子获得率为76.5%。这13对夫妇ICSI受精率为74.8%,可用胚胎率49.5%。3例新鲜周期移植,全部成功妊娠,1例已分娩1健康婴儿,另外2例持续妊娠中。其余10例行全胚冷冻,4例分别于胚胎冻存3个月后行解冻复苏移植,3例成功妊娠,2例已分娩(其中一例为非嵌合型Klinefelter综合征患者),另外1例持续妊娠中。结论睾丸显微切开取精术是使NOA患者和非嵌合型Klinefelter综合征患者成功获得自己遗传学子代的有效方法,有较高的精子获得率,联合ICSI技术、全胚冷冻-复苏移植可以获得较高的临床妊娠率。Objective:To observe the clinical effect of microdissection testicular sperm extraction(micro-TESE)combined with intracytoplasmic sperm injection(ICSI)in the treatment of non-obstructive azoospermia(NOA).Methods:17 patients with NOA all underwent micro-TESE.ICSI was performed in patients with positive sperm retrieval,and their fertilization rate,available embryo rate and clinical pregnancy outcome were analyzed.Results:13 out of 17 patients undergoing micro-TESE obtained sperm,with a sperm retrieval rate of 75.5%.The fertilization rate was 74.8%and available embryo rate was 49.5%.3 women were transferred embryos in their fresh cycles,and all of them were clinically pregnant.2 cases had delivered(one from a patient with Klinefelter syndrome)and the other 1 was ongoing pregnant.4 patients out of 10 freeze-all ET cycles resulted in 3 successful pregnancy.Conclusion:micro-TESE can help NOA patients including Klinefelter syndrome 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 and freeze-all ET.

关 键 词：显微取精术 KLINEFELTER综合征 非梗阻性无精子症 精子获得率 临床妊娠 

分 类 号：R446.144[医药卫生—诊断学]