单精子卵胞浆内穿刺术治疗男性不育症的探讨(附23例报告).docVIP

单精子卵胞浆内穿刺术治疗男性不育症的探讨(附23例报告) 临床泌尿外科杂志 2000年第4期第15卷 临床研究 作者：黄学锋　郑菊芬　周颖　林金菊　赵军招　叶碧绿　李澄棣 单位：温州医学院附属第一医院生殖医学中心，浙江温州，325000 关键词：单精子卵胞浆内穿刺术；男性不育症；妊娠 　　摘要　目的：探讨单精子卵胞浆内穿刺术（ICSI）治疗严重精液异常和梗阻性无精子症所致不育的疗效。方法：对23例严重精液异常和梗阻性无精子症患者施行ICSI，女方行常规超促排卵以获取卵子并选择成熟的卵母细胞，同时采用手淫法、经皮附睾穿刺术（PESA）和睾丸精子获取术（TESE）以获得精液、附睾及睾丸精子行ICSI。结果：23例23个治疗周期共获卵332个，其中300个成熟卵母细胞进行了ICSI，193（64.3%）个卵子正常受精，形成180个胚胎，每个治疗周期移植胚胎2～4个（平均3.07个），8例获得临床妊娠，2例系双胞胎，总周期临床妊娠率为34.8%。其中11例11个治疗周期采用精液精子行ICSI，4例妊娠；12例12个治疗周期采用附睾精子或睾丸精子，4例妊娠。结论：ICSI可以有效地治疗严重的精液异常和梗阻性无精子症所致的不育症。 Intracytoplasmic sperm injection for treatment of severe male infertility (Report of 23 cases) HUANG Xue-feng　ZHENG Ju-fen　ZHOU Ying　LIN Jin-ju 　　ZHAO Jun-zhao　YE Bi-lu　LI Cheng-di 　　(Reproduction Medicine Unit, Wenzhou Medical College 1st Affiliated Hospital, Wenzhou, Zhejiang，325000) 　　Abstract　Purpose:To investigate the efficacy of ICSI treatment for severe male factor infertility.Methods: The female partners were routinely superovulated and had oocyte retrieval under transvaginal ultrasound. MII oocyte was selected to be microinjected with a single spermatozoon, which was prepared from semen, PESA and TESE samples respectively .Results: Among 332 oocytes retrieved, 300 MII oocytes were microinjected, 193 (64.3%) oocytes were normally fertilized, 180 fertilized oocytes cleaved to embryos. 2～4 (mean 3.07) embryos were replaced into uterus for each transfer. 8 clinical pregnancies (2 twin) were achieved, with a pregnant rate per cycle of 34.8%. 4 pregnancies resulted from 11 ICSI cycles with semen spermatozoa and 4 from 12 cycles with epididymal or testicular spermatozoa. Conclusions: ICSI is an effective method to treat severe male infertility. 　　Key words　Intracytoplasmic sperm injection　Male infertility　Pregnancy 　　自1992年Palermo等〔1〕采用单精子卵胞浆内穿刺术（ICSI）治疗严重精液异常的男性不育症获得成功以来，ICSI已被广泛用于治疗男性严重不育症。我们于1999年2～8月采用ICSI技术治疗严重精液异常和梗阻性无精子症23例(23对夫妇，每例为1个治疗周期)，其中8例获得临床妊娠，现报告如下。 　　1　资料与方法 　　1.1　临床资料 　　本组不育夫妇23对，女方年龄21～39岁，平均30.1岁；男方年龄25～43岁，平均32.5岁。不育年限2～12年。4例为继发性不育，19