摘要
目的探讨梗阻性(OA)与非梗阻性无精子症(NOA)患者行卵胞浆内单精子注射(ICSI)的治疗结局。方法回顾性分析2012年1月至2015年12月在北京大学第一医院妇产科生殖与遗传中心行ICSI治疗的无精子症病例,选取不孕原因为单纯男性因素且女方年龄≤35岁,基础性激素水平正常的病例,共344个取卵周期,256个移植周期。根据睾丸组织病理分型将病例分为OA和NOA两组,比较两组的男、女方平均年龄、不孕年限、基础卵泡刺激素(FSH)值、促性腺激素(Gn)用量、Gn天数、注射人绒毛膜促性腺素(hCG)日雌二醇(E_2)值、hCG日孕酮(P)值、子宫内膜厚度、MⅡ卵数、受精率、可移植胚胎率、优质胚胎率、临床妊娠率、流产率及活婴出生情况。结果所有病例的ICSI受精率为72.68%(2208/3038)、受精失败发生率4.36%(15/344)、可移植胚胎率87.87%(1920/2185)、优质胚胎率36.93%(807/2185)、临床妊娠率56.25%(144/256),活婴出生率50.78%(130/256)。两组病例的平均年龄、不孕年限、基础FSH值、Gn用量、Gn天数、hCG日E_2值、h CG日P值、子宫内膜厚度、获卵数差异均无统计学意义。OA组的受精率及2PN受精率均显著高于NOA组(74.61%vs.65.93%,P<0.01;67.29%vs.54.96%,P<0.01),受精失败发生率OA组低于NOA组,差异有统计学意义(2.75%vs.8.99%,P<0.05)。2PN卵裂率、可移植胚胎率、优质胚胎率、临床妊娠率、胚胎种植率、流产率及活婴出生率在两组间差异均无统计学意义。结论与OA患者相比较,NOA患者的睾丸精子受精能力有所下降,但两者行ICSI治疗后的妊娠结局相似。
Objective To compare the outcome of intracytoplasmic sperm injection（ICSI）in men with obstructive and nun-obstructive azoospermia.Methods This study retrospectively investigated azoospermia patients receving ICSI treatment in the First Hospital of Beijing University from Jan. 2012 to Dec. 2015,whose infertile reason was only male factors,and in these patients the basal hormone was normal and the female age was ≤ thirty-five years. They finished 344 cycles of egg retrieval and 256 transplantation cycles. They were divided into OA group（n=255）and NOA group（n=79）according to histopathological types. Male and female age,infertile period,base FSH level,Gn dosage,Gn days,E2 and P level on h CG day,endometrial thickness,received oocyte number,fertilization rate,cleavage rate,quality embryo,clinical pregnancy rate,fetal miscarriage and live birth rate of all ICSI cycles and different groups were evaluated.Results The fertilization rate,fertilization failure rate,transferable embryo rate,good quality embryo rate of all azoospermia patients were 72.68%（2208/3038）,4.36%（15/344）,87.87%（1920/2185）and 36.93%（807/2185）respectively,with 144 pregnancies（56.25%,144/256）and the live birth rate was 50.78%（130/256）.The demographic and clinical factors,including male and female age,infertile period,female base FSH level,Gn dosage,Gn days,E_2 and P level on hCG day,endometrial thickness and received oocyte number were similar between two groups;there were also no difference in the embryo cleavage and quality,clinical pregnancy rate,implantation rate,fetal miscarriage or live birth rate between two groups,though the fertilization rate and 2 PN fertilization rate of OA group（74.61%,67.29%）were higher than NOA group（65.93%,54.96%,P0.01）;the fertilization failure rate of NOA group was higher than OA group（8.99% vs. 2.75%,P〈0.05）.Conclusion The fertility capability of testicular sperm in men with NOA is lower compared with OA,but the clinical pregnancy outcome of ICSI is similar between two groups.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2018年第2期203-208,共6页
Chinese Journal of Practical Gynecology and Obstetrics
