严重少精子症患者行卵胞浆内单精子注射治疗单个取卵周期累积活产率分析  

Cumulative live birth rate per oocytes retrieved cycle of patients with severe oligospermia undergoing ICSI treatment

作　　者：倪运萍 陆杉 卢兴宏 徐珉 刘娟 王爱爱 袁启龙 谢妍 杨冬宇 周文 Ni Yun-ping;LU Shan;LU Xing-hong;XU Min;LIU Juan;WANG Ai-ai;YUAN Qi-long;XIE Yan;YANG Dong-yu;ZHOU Wen(Reproductive Medicine Department,Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006)

机构地区：[1]广州中医药大学第二附属医院生殖医学科,广州510006

出　　处：《生殖医学杂志》2020年第7期893-899,共7页Journal of Reproductive Medicine

基　　金：广东省中医药局科研项目(20180116)。

摘　　要：目的分析严重少精子症患者行卵胞浆内单精子注射(ICSI)治疗的单个取卵周期累积活产率。方法回顾性分析2014年1月至2019年9月在本院生殖医学科因男方严重少精子症为主要指征接受ICSI治疗的187对不育夫妇的临床资料,其中8对夫妇伴有男方染色体异常,单独列出分析。将最终纳入的179对夫妇的240个取卵周期按照女方年龄分为≤35岁、36~39岁、≥40岁组;按照获卵数不同分为≤5枚、6~10枚、11~15枚、≥16枚组,比较各组的移植胚胎情况及累积临床妊娠率和累积活产率。结果179对夫妇目前的单个取卵周期累积活产率为50.00%(96/192)。≤35岁组、36~39岁组、≥40岁组的获卵数、可利用胚胎数、累积临床妊娠率及活产率比较均有显著性差异(P<0.05),随着女方年龄的增加,获卵数、可利用胚胎数、累积临床妊娠率及累积活产率均呈下降的趋势。不同获卵数组间比较,随着获卵数的增加,可利用胚胎数显著增加(P<0.05)。获卵数≥6枚的各组与≤5枚组比较,女方年龄、无可利用胚胎率、平均移植胚胎数、平均移植优胚数、累积临床妊娠率、累积活产率均显著升高(P<0.05)。获卵数≤5枚时,≤35岁组累积临床妊娠率与累积活产率均显著高于>35岁组(P<0.05)。8对男方染色体异常夫妇接受遗传咨询后,均要求行ICSI治疗,共进行13个取卵周期治疗,5例获得临床妊娠,4例获得足月分娩,1例分娩1名男婴,其余3例各分娩1名女婴。结论男方严重少精子症患者接受ICSI治疗的妊娠结局仍然与女方年龄及获卵数相关,因此建议这类患者应尽早接受助孕治疗;对于合并男性染色体异常的患者应给予遗传咨询,尽量减少遗传风险。Objective:To explore the cumulative live birth rate per oocytes retrieved cycle of intracytoplasmic sperm injection(ICSI)for the patients with severe oligospermia.Methods:The clinical data of 187 infertile couples who received ICSI treatment due to male severe oligospermia in the Department of Reproductive Medicine of our hospital from January 2014 to September 2019 were retrospectively analyzed.Among them,eight couples were accompanied by male chromosome abnormalities,which were listed and analyzed separately.The 240 oocytes retrieval cycles of the 179 couples were finally included.According to the age of the woman,they were divided into≤35,36-39 and≥40 years old group.According to the number of oocytes collected,they were divided into≤5,6-10,11-15 and≥16 group.The embryo transfer status,cumulative clinical pregnancy rate and cumulative live birth rate were compared among the groups.Results:The cumulative live birth rate of 179 couples per oocytes retrieval cycle was 50.00%(96/192).There were significant differences in the number of oocytes retrieved,the number of available embryos,the cumulative clinical pregnancy rate and the live birth rate among the≤35,36-39 and≥40 year old group(P<0.05).The number of oocytes retrieved,the number of available embryos,the cumulative clinical pregnancy rate,and the cumulative live birth rate all show a downward trend along with the increase of woman age.Comparing the groups with different number of oocytes retrieved,the number of available embryos increased significantly as the number of oocytes retrieved increased(P<0.05).The age of woman,the rate of unavailable embryos,the average number of embryos transferred,the average number of embryos transferred,the cumulative clinical pregnancy rate,and the cumulative live birth rate in the groups with number of oocytes retrieved≥6 were significantly increased comparing the groups with number of oocytes retrieved≤5(P<0.05).When the number of oocytes retrieved≤5,the cumulative clinical pregnancy rate and cumulative li

关 键 词：严重少精子症 卵胞浆内单精子注射 累积临床妊娠率 累积活产率 

分 类 号：R698.2[医药卫生—泌尿科学]