精子激活剂应用于梗阻性无精症患者ICSI的比较分析  

Comparative analysis on the application of sperm activator for ICSI patients with obstructive azoospermia

作　　者：彭涛 鞠海宇 赵立晓 张喜贤 PENG Tao;JU Haiyu;ZHAO Lixiao;ZHZNG Xixian(Department of Reproductive Medicine,Yunnan jiuzhou Hospital,Kunming Yunnan 650000,China)

机构地区：[1]云南锦欣九洲医院生殖医学科,云南昆明650000

出　　处：《云南医药》2023年第1期10-13,共4页Medicine and Pharmacy of Yunnan

基　　金：昆明市卫生健康委员会卫生科研课题(2020-05-01-118)。

摘　　要：目的睾丸或附睾穿刺获得的精子经过含有PF的精子激活剂处理后,挑选出活动精子行ICSI,最后比较分析相关指标。方法研究分为观察组91例患者,男方行睾丸/附睾穿刺抽吸取精术或者解冻此前手术获得精子,经过激活处理后,选活动的精子行ICSI操作;对照组选择未行激活的此类患者77例,显微镜下机械接触法选活动精子行ICSI。对2组的受精率、卵裂率、可用胚胎率、囊胚形成率、临床妊娠率等指标比较分析。结果2组间的受精率(81.3%VS 79.5%)、卵裂率(97.1%VS 98.1%)差异无统计学意义(P>0.05)。可利用胚胎率(55.5%VS 46.1%,P=0.008)、囊胚形成率(57.8%VS 46.0%,P=0.007)均有提高。2组均没有分娩畸形胎儿。另在冷冻睾丸/附睾精子亚组中,观察组的受精率、正常受精率均有高于对照组的趋势,但样本量较小,尚无统计学意义。结论对睾丸(附睾)精子,尤其是对冷冻复苏后的精子行激活处理,可帮助实验室操作人员镜检并挑选出活动精子行ICSI,获得较为理想的实验室及临床结局,而且未发现危害。Objective sperm obtained by testicular or epididymal puncture were treated with sperm activator containing PF,and motile sperm were selected for ICSI,and the relevant indicators were compared and analyzed at last.Methods The study was divided into observation group A with 91 patients,the male underwent testicular/epididymal puncture aspiration method or thawed prior operations to obtain sperm.After activation treatment,active sperm were selected for ICSI operation.In control group,77 cases of such patients without activation were selected and motile sperm were selected for ICSI by mechanical contact method under microscope.The index of fertility rate,cleavage rate,available embryo rate,blastocyst formation rate and clinical pregnancy rate were compared and analyzed between the two groups.Results There was no statistical significance in the difference of fertility(81.3%VS 79.5%)and cleavage rate(97.1%VS 98.1%)(P>0.05)in the two groups.Both available embryo(55.5%VS 46.1%,P=0.008)and blastocyst formation rate(57.8%VS 46.0%,P=0.007)increased.There were no malformed fetuses in the two groups.In addition,in the frozen testicular/epididymal sperm subgroup,the fertilization rate and normal fertilization rate of observation group A were higher than that of observation group B,but the sample volume was less and there was no statistical significance.Conclusions Activation of testicular/epididymal sperm,especially sperm after cryoresuscitation,can help laboratory operators to microscopy and select motile sperm for ICSI,and achieve ideal laboratory and clinical outcomes,and no harm was found.

关 键 词：无精子症 睾丸穿刺术 卵细胞胞质内单精子注射 己酮可可碱 

分 类 号：R698.2[医药卫生—泌尿科学]