严重少弱精子症患者的辅助生育结局和安全性分析  

Analysis of the outcome and safety of assisted reproduction in patients with severe oligonasthenospermia

作　　者：刘杨青 王可欣 丁孝芹[1] 高松占 冯浩[1] 娄华[2] 李真[2] 嘉若琳 杨险峰[1] Liu Yangqing;Wang Kexin;Ding Xiaoqin;Gao Songzhan;Feng Hao;Lou Hua;Li Zhen;Jia Ruolin;Yang Xianfeng(Department of Andrology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Reproduction Center,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院男性科,郑州450052 [2]郑州大学第三附属医院生殖医学中心,郑州450052

出　　处：《国际泌尿系统杂志》2024年第2期289-293,共5页International Journal of Urology and Nephrology

摘　　要：目的探讨严重少弱精子症患者的辅助生育结局及安全性。方法选取2015年9月至2019年12月在本院接受卵胞质内单精子注射(ICSI)治疗的严重少弱精子症患者(严重少弱精组,183例)和接受经皮附睾精子抽吸术(PESA)取精的梗阻性无精子症患者(对照组,183例)的临床资料,比较两组的正常受精率、正常卵裂率、可利用胚胎率、优胚率、女方妊娠结局、新生儿结局及出生缺陷。结果严重少弱精组的植入率、妊娠率、可利用胚胎率均低于对照组,差异均有统计学意义(均P<0.05)。严重少弱精组的正常受精率和优质胚胎率均低于对照组,而正常卵裂率高于对照组,但差异均无统计学意义(均P>0.05)。严重少弱精组的临床妊娠114例,分娩104例,而对照组的临床妊娠132例,分娩118例。两组的流产率、异位妊娠率、双胎率等指标比较方面,差异均无统计学意义(均P>0.05)。严重少弱精组患者中,单胎分娩76例,活产数为76例;双胎分娩28例,活产数为56例。对照组患者中,单胎分娩83例,活产数为83例;双胎分娩35例,活产数为70例。在单胎、双胎分娩周期中,两组的自然分娩率、早产率、低出生体重儿、性别比(男/女)方面等指标比较,差异均无统计学意义(均P>0.05)。严重少弱精组患者的1例新生儿存在左外耳廓凹陷;对照组无出生缺陷新生儿,差异无统计学意义(P>0.05)。结论相比于梗阻性无精子症者,严重少弱精子症者在新鲜胚胎移植中的可利用胚胎率、植入率、妊娠率偏低,但两组患者妊娠后和新生儿的情况无差异,到出生阶段是安全的。Objective To investigate the outcome and safety of assisted reproduction in patients with severe oligonasthenospermia.Methods The clinical data of 366 patients with severe oligonasthenospermia who received intracytoplasmic single sperm injection(ICSI)treatment(severe oligonasthenospermia group,183 cases)and patients with obstructive azoospermia who underwent percutaneous epididymal sperm aspiration(PESA)sperm retrieval(control group,183 cases)were selected from September 2015 to December 2019 in our hospital.The normal fertilization rate,normal cleavage rate,available embryo rate,superior embryo rate,female pregnancy outcome,neonatal outcome and birth defect were compared between the two groups.Results The implantation rate,pregnancy rate,and rate of available embryos in the severe oligonasthenospermia group were lower than those in the control group,and the differences were all statistically significant(all P<0.05).The normal fertilization rate and the rate of high-quality embryos in the severe oligonasthenospermia group were lower than those in the control group,while the rate of normal cleavage was higher than that in the control group,and none of the differences was statistically significant(all P>0.05).There were 114 clinical pregnancies and 104 deliveries in the severe oligonasthenospermia group,while there were 132 clinical pregnancies and 118 deliveries in the control group.In terms of the comparison of miscarriage rate,ectopic pregnancy rate and twin pregnancy rate between the two groups,the differences were not statistically significant(all P>0.05).In the severe oligonasthenospermia group,there were 76 live births in 76 singleton births and 56 live births in 28 twin births.In the control group,there were 83 live births in 83 singleton births and 70 live births in 35 twin births.There was no statistical significance in the natural delivery rate,premature birth rate,low birth weight infants,and sex ratio(male/female)between the two groups in the single and twin delivery cycles(all P>0.05).One neonate of p

关 键 词：弱精子症 无精子症 不育 男(雄)性 妊娠结局 先天畸形 

分 类 号：R698.2[医药卫生—泌尿科学]