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目的:评估卵细胞浆内单精子注射(ICSI)在常规治疗失败的死精子症造成的男性不育症中的应用价值。方法:8例经过常规治疗无效的死精子症患者,均表现为精子完全不运动。采用常规ICSI方法治疗,随访受精率、β-HCG阳性率、临床妊娠及分娩等结局参数,并与同期使用活动精子进行ICSI的患者(对照组)对比。结果:死精子症组与对照组在男女方年龄、取卵数上的差异无统计学意义(P>0.05),死精子症组的受精率平均为62.3%(14%～100%),对照组为71.9%(40%～100%),差异无统计学意义(P>0.05)。死精子症组5例患者胚胎移植后血清β-HCG升高,其中4例获得临床妊娠(1例活产,2例继续妊娠,1例孕8+周胚胎停育);对照组5例血清β-HCG升高,均获得临床妊娠,包括3例足月活产和2例继续妊娠。结论:采用ICSI治疗常规治疗失败的死精子症男性不育症患者,受精率及临床妊娠情况令人满意,是一种可行的治疗方法。
OBJECTIVE: To evaluate the value of intracytoplasmic sperm injection (ICSI) in male infertility caused by conventional treatment-failed spermatozoa. Methods: Eight patients with spermatozoa that were ineffective after routine treatment showed no movement of spermatozoa. The outcomes of routine ICSI treatment, follow-up fertilization rate, β-HCG positive rate, clinical pregnancy, childbirth and other outcome parameters were compared with those of ICSI patients with active spermatozoa during the same period (control group). Results: There was no significant difference in the ages of male and female and the number of oocytes retrieved between the dead sperm group and the control group (P> 0.05). The average fertilization rate of dead sperm group was 62.3% (14% -100%). Group was 71.9% (40% -100%), the difference was not statistically significant (P> 0.05). Serum levels of β-HCG increased after embryo transfer in 5 patients with dead spermatozoa, among which 4 patients received clinical pregnancy (1 live birth, 2 pregnant women continued pregnancy and 1 pregnant fetus was stopped at 8+ weeks). In the control group, 5 cases of serum β-HCG increased, were clinical pregnancy, including 3 cases of full-term live births and 2 cases of continued pregnancy. CONCLUSIONS: ICSI is a viable treatment for infertile men with spermicidal indications who have failed routine treatment and have satisfactory fertilization rates and clinical pregnancy.