经皮睾丸微穿刺活检后冷冻精子的卵胞质内单精子注射

目的:对经皮睾丸微穿刺活检后冷冻保存精子卵胞质内单精子注射(ICSI)治疗非梗阻性无精子症所致不育进行临床总结,并对其影响治疗结果的因素进行探讨。方法:对62例非梗阻性无精子症患者进行经皮睾丸微穿刺活检,发现活动精子者(35例)对睾丸活检组织进行冷冻保存;女方促排卵常规使用促性腺激素释放激动剂(GnRHa)/卵泡刺激素(FSH)/人绒毛膜促性腺激素(hCG)方案,B超监测卵泡发育情况并引导经阴道取卵,冷冻的睾丸组织解冻后行ICSI,良好胚胎进行移植。结果:取卵周期为35个,冷冻的睾丸精子解冻后行ICSI,35个周期进行常规胚胎移植。13例临床妊娠。启动周期、取卵周期与移植周期临床妊娠率均为37.14%(13/35)。结论:经皮睾丸微穿刺活检后ICSI是治疗非梗阻性无精子症所致不育的最主要和有效的方法;活检后对有活动精子的睾丸组织进行冷冻保存不影响治疗结果,可以减少患者睾丸活检的次数,减轻患者痛苦。

Intracytoplasmic Sperm Injection Using Cryopreserved-thawed Testicular Spermatozoa with Testicular Fine Needle Aspiration

Objective: To evaluate the effect of intracytoplasmic sperm injection (ICSI) using cryopreserved-thawed testicular spermatozoa with testicular fine needle aspiration (TEFNA) in patients with non-obstructive azoospermia.Methods: Sixty-two patients underwent TEFNA. Mature testicular spermatozoa were found in 35 cases of patients and the testicular tissues were cryopreserved for later ICSI. Ovarian stimulation included a long protocol of GnRHa/FSH/hCG. Oocyte retrieval was performed under transvaginal ultrasound guidance, and ICSI conducted with cryopreserved-thawed testicular spermatozoa.Results: A total of 35 couples underwent 35 ICSI cycles using cryopreserved-thawed testicular spermatozoa with testicular fine needle aspiration. The clinical pregnancy rate was (37.14)% (13/35).Conclusion: ICSI using cryopreserved-thawed testicular spermatozoa with testicular fine needle aspiration is a main and effective method in the treatment of non-obstructive azoospermia, which can avoid further testicular fine needle aspiration.