睾丸细针抽吸取精行ICSI治疗阻塞性无精子症

目的 :探讨睾丸细针抽吸技术 (TEFNA)和睾丸精子行卵胞浆内单精子注射 (ICSI)治疗阻塞性无精子症(OAS)的可行性和效果。　方法 :对 14对因男性OAS引起不育的夫妇进行 15个周期的TEFNA +ICSI治疗 ,女方常规促超排卵 ,在取卵当日从男方睾丸用细针抽吸精曲小管 ,经体外处理、培养后 ,选择精子行ICSI,其中 14个周期使用活动精子 ,1例病人同时采用附睾精子和睾丸精子。　结果 :共获卵子 15 2个 ,成熟卵 132个 ,受精卵 82个 (6 2 .1% ) ;共行胚胎移植 14个周期 ,平均移植胚胎 2 .5个 ,临床妊娠 11例。　结论 :TEFNA易操作 ,创伤小 ,并发症少 ;从睾丸组织中分离活动精子行ICSI是治疗男性无精子症的一种有效方法。

Testicular Fine Needle Aspiration and Intracytoplasmic Sperm Injection for Obstructive Azoospermia

Objectives: To determine the feasibility of obtaining mature sperm for intracytoplasmic sperm injection (ICSI) by testicular fine needle aspiration (TEFNA) in men diagnosed with obstructive azoospermia (OAS). Methods: 14 patients underwent 15 TEFNA+ICSI cycles. Gentle motile sperm was obtained in 14, the other one with non motile sperm. Epididymal and testicular sperm was used in one patient. Results: In 15 cycles, 132 mature oocytes were injected, and 82 (62.1%) were normally fertilized. 35 embryos were transferred in 14 cycles resulting in 11 clinical pregnancies. Conclusions: TEFNA is safe, efficient, easy to learn and well tolerated by all patients with less side effects. Higher pregnancy rate might be obtained. The effect with testicular sperm is better than epididymal sperm in some cases. Infertility caused by OAS can be treated with ICSI using sperm aspirated from testicle.