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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 2 3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 :2 3例 2 3个治疗周期共获卵 332个 ,其中 30 0个成熟卵母细胞进行了 ICSI,193(6 4.3% )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 3.0 7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。
Objective: To investigate the therapeutic effect of intracytoplasmic sperm injection (ICSI) on infertility caused by severe sperm abnormality and obstructive azoospermia. Methods: ICSI was performed in 23 patients with severe sperm abnormality and obstructive azoospermia. The female patients underwent routine hyperstimulation to obtain oocytes and select mature oocytes. Masturbation, transcutaneous epididymal puncture (PESA) and Testicular sperm harvesting (TESE) for sperm, epididymis and testicular sperm ICSI. RESULTS: A total of 332 eggs were obtained in 33 out of 23 treatment cycles, among which 30 0 mature oocytes were ICSI and 193 (6 4.3%) oocytes were fertilized normally to form 180 embryos. Embryos 2 to 4 (average 3.07), 8 cases of clinical pregnancy, 2 cases of twins, the total cycle clinical pregnancy rate was 34.8%. Eleven of the 11 treatment cycles adopted sperm sperm ICSI, 4 cases of pregnancy; 12 cases of 12 cycles of treatment with epididymal sperm or testicular sperm, 4 cases of pregnancy. Conclusion: ICSI can effectively treat severe semen abnormalities and obstructive azoospermia caused by infertility.