不同源性精子经ICSI-ET助孕术后的临床结局及子代安全性研究  

Clinical outcome and safety of offspring between Epididymal or testicular sperm and ejaculated sperm after ICSI-ET

作　　者：贺晓 李博 孙丹 黄剑磊 He Xiao;Li Bo;Sun Dan;Huang Jianlei(Department of Reproductive Medicine Center,Tangdu Hospital of the Air Force Military Medical University,Xi'an 710038)

机构地区：[1]空军军医大学唐都医院妇产科生殖医学中心,陕西西安710038

出　　处：《中国男科学杂志》2020年第3期3-6,10,共5页Chinese Journal of Andrology

摘　　要：目的探讨附睾/睾丸穿刺取精精子及射出精子经ICSI-ET助孕术后临床妊娠结局及子代安全性有无差别。方法采用回顾性队列研究,选择2017年1月至2019年5月行ICSI-ET助孕并新鲜胚胎移植的1248个周期为研究对象,根据男方取精方式的不同分为两组,即附睾/睾丸穿刺取精组(n=230)和对照组(n=1018),比较分析两组患者的一般情况、促排卵实验室指标、临床结局及围产期结局指标。结果手术取精组患者平均获卵数[(12.62±4.19)&(11.74±4.03)]及MⅡ卵数[(10.70±4.17)&(9.79±3.83)]相比对照组较多,但是ICSI后的受精率(77.02%&79.28%)及正常受精率(72.16%&74.56%)低于对照组,P值均<0.05。手术取精组平均临床妊娠率高于对照组(65.22%&57.86%),有统计学差异(P<0.05);但是两组间的多胎率、早期流产率、胎儿畸形引产率、活产率、剖宫产率、<37周早产率及双胎活产的构成比均无统计学差异(P>0.05),单胎活产或双胎活产的子代出生孕周和出生体重均无统计学差异(P>0.05)。结论不同源性的精子经ICSI-ET助孕后主要影响受精率,手术取精精子经ICSI-ET后临床妊娠率优于射精精子,围产期结局及子代安全性并无差异。Objective To explore the difference of clinical pregnancy outcome and offspring safety after ICSI-ET with epididymal or testicular sperm and ejaculated sperm.Methods The study was a retrospective cohort study.A total of 1284 ICSI-ET cycles with fresh embryo transferred from January 2017 to May 2019 were selected as the study subjects.According to the different ways of men's sperm extraction,they were divided into two groups:epididymal or testicular puncture group(n=230)and control group(n=1018).The general situation,the COS and laboratory parameters,clinical outcomes and perinatal outcomes of the two groups were compared.Results There were relatively more oocytes obtained[(12.62±4.19)&(11.74±4.03)]and MⅡoocytes[(10.70±4.17)&(9.79±3.83)]in the operative group compared with the control group.But the fertilization rate(77.02%&79.28%)and normal fertilization rate(72.16%&74.56%)after ICSI were lower than those in the control group(P<0.05).The average clinical pregnancy rate of the operative group was higher than that of the control group(65.22%&57.86%).But there was no significant difference between the two groups(P>0.05)in the multiple birth rate,early abortion rate,induced labor rate because of fetal malformation,live birth rate,cesarean section rate,preterm birth rate of<37 weeks and the proportion of live twin birth(P>0.05).There was no significant difference in gestational age and birth weight between the two groups(P>0.05).Conclusion There is probably significant difference between the two groups in the fertilization rate.The clinical pregnancy rate after ICSI-ET using epididymal or testicular sperm may be higher than that of ejaculated sperm.There is no difference in perinatal outcomes and offspring safety after ICSI-ET with epididymal or testicular sperm and ejaculated sperm.

关 键 词：单精子卵胞浆内注射 取精术 妊娠结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]