126例梗阻性无精子症借助ICSI治疗的临床结局分析

目的 探讨梗阻性无精子症采用不同方式获取的精子对卵胞浆内单精子注射术（ICSI）治疗的妊娠结局.方法 根据获取精子的方式不同将梗阻性无精子症患者分为两组：TESA组46例、PESA组80例,两组患者均行ICSI治疗.比较两组受精率、卵裂率、优质胚胎率、种植率及临床妊娠率等.结果 TESA组与PESA组的卵裂率分别为882%和942%,优质胚胎率分别为622%和625%,两组比较差异均无统计学意义（P〉005）.两组受精率分别为721%和776%,种植率分别为233%、348%,临床妊娠率分别431%、687%,两组比较差异均有统计学意义（P〈005）.结论 PESA或TESA结合ICSI是治疗梗阻性无精子症的有效治疗方法,附睾精子优于睾丸精子,可首选抽取附睾精子.

The analysis of clinical outcomes with ICSI treatment in 126 cases with obstructive azoospermia

Objective To compare the pregnancy outcomes of intracytoplasmic sperm injection （ICSI） treatment with sperm retrieved by different ways in obstructive azoospermia. Metheds According to different ways to get the sperm in ob- structive azoospermia patients, they were divided into two groups： TESA 46 cases, PESA group of 80 patients. Two groups of patients underwent ICSI treatment, and then the rate of fertilization, the rate of cleavage, the rate of high quality embryo, the rate of embryo implantation and pregnancy rate were compared between the two groups. Results The group of TESA of cleav- age rate,high - quality embryo rate is respectively 88.2% vs 94. 2% ,62.2% vs 62.5%. by statistical analysis of more than two indicators, no significant difference （P 〉 0. 05 ）were found. However, fertilization rate, implantation and clinical rate of pregnancy is respectively 72. 1% vs 7＂7.6%, 23.3% vs 34. 8%, 43.1% vs 68.7%, and then significant difference （ P 〈 0. 05） were found. Conclusion PESA or TESA with ICSI is a effective treatment for obstructive azoospermia. Epididymis is the important position of capacitation and sperm iotelcosis. Epididymal sperm shoud be choosen first for ICSI.