睾丸抽吸取精术结合 ICSI 治疗无精子症的研究

目的:通过观察睾丸抽吸取精结合胞浆内单精子注射技术( TESA - ICSI)治疗无精子症的临床妊娠率,并与传统IVF、ICSI方法对比,以提高治疗无精子症的疗效.方法:选取不育症患者451例,将所有患者以助孕方法分为IVF、ICSI、无精子症三组,以睾丸体积和血清FSH将80例无精子患者分为三组(A组睾丸体积正常、血清FSH值正常；B组睾丸体积偏小,血清FSH值正常；C组睾丸体积小于正常,血清FSH值明显增高),三组患者均采用睾丸穿刺取精,并对获取精子者行TESA - ICSI助孕.结果:80例无精子症患者中,总共有42例成功获取精子,成功率为52.5％,其中A、B、C三组成功率分别为88.57％、47.37％、7.70％；其中29例成功妊娠,临床妊娠成功率为72.50％.IVF、ICSI组临床妊娠成功率分别为42.51％、47.62％,经x2检验分析,无精子症患者组临床妊娠率明显高于常规IVF组和ICSI组,差异有显著意义.结论:睾丸抽吸取精术结合ICSI技术是治疗无精子症的有效方法.

Research of Testicular Sperm Aspiration Combine with Intracytoplasmic Sperm Injection to Treat Azoospermatism

Objective:To compare the pregnancy rate and treatment efficacy of azoospermatism between TESA-ICSI and IVF.Methods:A total of 451 cases of sterile patients were divided into the IVF group(n=287),the ICSI group(n=84) and azoospermia group(n=80);and the azoospermia group were divided into subgroups A(n=35) in which had normal testicular volume and serum level of FSH,subgroup B(n=19) in which had small testicular volume and normal serum FSH level and subgroup C(n=26) in which had smaller testicular volume and higher FSH level;they received testicular sperm aspiration and treatment of ICSI(TESA-ICSI) progesterone.Results:40 of 80 cases of azoospermia were successfully obtained sperm(52.5%).The success rate of group A,B and C was 88.57%、47.37 and 7.70% respectively.Cases of successful pregnancy was 122(72.50%),40(42.51%) and 29(47.62%) in IVF,ICSI and azoospermia group respectively.X2 test analysis showed clinical pregnancy rate in azoospermia group was significantly higher than IVF group and simple ICSI group(P<0.01).Conclusions:Testicular sperm aspiration combined with ICSI(TESA-ICSI) is an effective method for treatment of azoospermatism.