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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 |
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黄学锋 郑菊芬 周颖 林金菊 赵军招 叶碧绿 李澄棣
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。
关键词 单精子卵胞浆内穿刺术 男性不育症 妊娠
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[1] [2] 下一页
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