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目的分析比较不同病因患者睾丸穿刺取精行卵泡浆内单精子注射胚胎移植(introcytoplasmicsperm injection-embryo transplantation,ICSI)治疗的临床结局。方法回顾性分析生殖中心睾丸穿刺取精行ICSI患者的治疗情况,将50个睾丸穿刺取精周期分为:A组(精子参数严重异常组)、B组(射精功能障碍组:药物治疗无效的逆行射精、不射精或临时取精困难患者)和C组(无精子症组),比较3组ICSI治疗周期的受精率、正常受精率、卵裂率、优质胚胎率、临床妊娠率及胚胎种植率等指标。结果 3组在受精率、正常受精率、卵裂率、临床妊娠率和胚胎种植率等指标方面差异无统计学意义,但A组和C组的临床妊娠率(36.4%和46.2%)及胚胎种植率(26.1%和34.0%)高于B组(15.4%和12.0%);3组优质胚胎率之间差异有统计学意义(P<0.05),B组和C组(67.1%和65.4%)明显高于A组(44.8%)。结论睾丸取精行ICSI助孕是严重男性因素不育的有效治疗手段之一,但不同病因患者睾丸穿刺取精后ICSI治疗的临床指标有差异,在比较不同来源精子对临床结局的影响时,注意各病因患者的构成比。
Objective To compare and analyze the clinical outcomes of intracytoplasmic sperm injection-embryo transplantation (ICSI) by testicular perforation in different etiology. Methods Retrospective analysis of the treatment of ICSI patients in the reproductive center for testicular biopsy, 50 testicular aspirate sperm retrieval cycles were divided into: A group (severe abnormal sperm parameters group), B group (ejaculation dysfunction group: drug treatment ineffective Retrograde ejaculation, ejaculation or temporary ejaculation difficult patients) and group C (azoospermia group). The fertilization rate, normal fertilization rate, cleavage rate, high quality embryo rate, clinical pregnancy rate and embryo implantation Rate and other indicators. Results There were no significant differences in fertilization rate, normal fertilization rate, cleavage rate, clinical pregnancy rate and embryo implantation rate among the three groups, but clinical pregnancy rates (36.4% and 46.2%) in A and C groups and embryos (26.1% and 34.0%) were higher than those in group B (15.4% and 12.0% respectively). There was a significant difference in the quality embryos among the three groups (P <0.05) ) Was significantly higher than group A (44.8%). Conclusion ICSI assisted testicular spermatogenesis is one of the most effective treatments for infertility of male patients. However, there are differences in clinical indications of ICSI after testicular sperm injection in patients with different etiologies. When comparing the effects of different sources of sperm on clinical outcomes, Pay attention to the composition of patients with various causes.