他莫昔芬联合左卡尼汀对特发性少弱精子症患者体外受精结局的疗效观察  

Observation on the effect of tamoxifen combined with L-carnitine on the outcome of in vitro fertilization in patients with idiopathic oligoasthenospermia

作　　者：余柯达[1] 师帅[1] 毛佳婷 包云 柴娟[1] 朱佳 Yu Keda;Shi Shuai;Mao Jiating;Bao Yun;Chai Juan;Zhu Jia(Center of Reproductive Medicine,Jinhua People's Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市人民医院生殖医学中心,浙江金华321000

出　　处：《中国男科学杂志》2025年第1期105-110,共6页Chinese Journal of Andrology

基　　金：浙江省医药卫生科技计划项目(2022KY1333);金华市科学技术研究计划项目(2021-4-222,2023-3-138);金华市中医药科学技术研究计划项目(2023KY07)。

摘　　要：目的探讨他莫昔芬(TMX)联合左卡尼汀(LC)对特发性少弱精子症(iOAT)患者精液质量和体外受精(IVF)结局的改善作用。方法选取2022年1月至2023年6月在本院行IVF助孕治疗的150例iOAT患者,根据治疗方法分为三组,每组各50例,TMX+LC治疗组联用TMX和LC治疗,TMX治疗组单用TMX治疗,LC治疗组单用LC治疗。比较三组治疗前后血清性激素、精液质量及IVF治疗的受精、胚胎发育、临床妊娠情况。结果治疗前三组血清性激素和精液质量差异无统计学意义(P>0.05)。治疗后TMX+LC治疗组和TMX治疗组的卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)和精子浓度均显著高于LC治疗组(均P<0.0167),TMX+LC治疗组和LC治疗组的前向运动精子百分率(PR)、正常形态精子百分率和精子DNA碎片指数(DFI)显著优于TMX治疗组(均P<0.0167)。TMX+LC治疗组的IVF正常受精率显著高于TMX治疗组和LC治疗组,TMX+LC治疗组和LC治疗组的可移植胚胎率和优质胚胎率均显著高于TMX治疗组(均P<0.0167),TMX+LC治疗组的周期取消率低于TMX治疗组和LC治疗组;三组的移植胚胎数、胚胎种植率、临床妊娠率、多胎妊娠率和异位妊娠率均无显著差异性(均P>0.05),TMX治疗组的早期流产率高于TMX+LC治疗组和LC治疗组。结论TMX联合LC的应用可有效提升iOAT患者血清性激素水平和精液质量,改善IVF治疗iOAT患者的受精、胚胎发育和妊娠结局。Objective To investigate the effect of tamoxifen(TMX)combined with L-carnitine(LC)on semen quality and in vitro fertilization(IVF)outcome in patients with idiopathic oligoasthenospermia(iOAT).Methods A total of 150 patients with iOAT who underwent IVF assisted pregnancy treatment in our hospital from January 2022 to June 2023 were selected and divided into three groups according to the treatment methods,50 cases in each group.The patients in the TMX+LC treatment group was treated with TMX and LC,the patients in the TMX treatment group with TMX alone,and the patients in the LC treatment group with LC alone.The serum sex hormones and semen quality of the three groups before and after treatment were compared,and the fertilization,embryo development and clinical pregnancy of the three groups of IVF treatment were compared.Results Before treatment,there were no significant differences in serum sex hormones and semen quality among the three groups(P>0.05).After treatment,follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T)and sperm concentration in TMX+LC treatment group and TMX treatment group were all significantly higher than those in LC treatment group(all P<0.0167).Progressive sperm motility(PR),normal morphology sperm rate and sperm DNA fragmentation index(DFI)in TMX+LC treatment group and LC treatment group were all prominently better than those in TMX treatment group(all P<0.0167).After IVF treatment,the normal fertilization rate of TMX+LC treatment group was obviously higher than that of TMX treatment group and LC treatment group,the transplantable embryo rate and high-quality embryo rate of TMX+LC treatment group and LC treatment group were all remarkably higher than those of TMX treatment group(all P<0.0167),and the cycle cancellation rate of TMX+LC treatment group was lower than that of TMX treatment group and LC treatment group.After embryo transfer,there were no significant differences in the number of embryos transferred,embryo implantation rate,clinical pregnancy rate,multiple pregn

关 键 词：少精子症 弱精子症 他莫昔芬 左卡尼汀 体外受精 

分 类 号：R698.2[医药卫生—泌尿科学]