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目的:探讨严重男性不育患者借助卵胞质内单精子注射(ICSI)技术出生子代的生长和智力发育情况。方法:对接受ICSI/IVF治疗的237个家庭出生的300例子代进行召回后现场随访,并进行全面体格检查和智力测试,按ICSI/IVF当日精液情况和受精方式分为4组,附睾/睾丸精子ICSI组患者92例,子代118例(A组);严重少/弱精子ICSI组患者84例,子代106例(B组);其它精子ICSI组患者35例,子代42例(C组);正常精子IVF组患者26例,子代34例(D组)(C组和D组为对照组)。结果:受访子代实足年龄4~84个月,平均33.5个月,4组子代绝大部分身高和体质量达同龄儿童标准范围。婴幼儿组有51例进行Gesell智力量表检测,A、B组和C/D对照组分别检测了17、24、10例,无一例存在明显智力障碍;学龄前儿童组96例进行了WPPSI-R智力量表检测,A、B和C/D对照组分别检测了50、30、16例,语言智力评分分别为105±20分、103±21分、115±16分(P=0.119),操作智力评分分别为124±18分、120±24分、125±17分(P=0.64),总智力评分分别为116±18分、112±23分、122±15分(P=0.303)。结论:无精子症和严重少/弱精子症等严重男性不育症患者ICSI子代的生长和智力发育情况与较好精子或正常精子ICSI/IVF子代相比无统计学差异。
Objective: To investigate the growth and mental development of offspring born in severe male infertility with intracytoplasmic sperm injection (ICSI). Methods: A total of 300 offspring born in 237 families receiving ICSI / IVF were investigated on the spot and followed up on a full physical examination and intelligence test. According to the semen status and fertilization method on the day of ICSI / IVF, they were divided into 4 groups: epididymal / testis There were 92 patients in the sperm ICSI group and 118 children in the offspring group (group A); 84 patients in the severe oligo / weak sperm ICSI group and 106 children in the sperm group (group B); 35 patients in the sperm ICSI group and 42 children in the sperm group Group); normal sperm IVF group of 26 patients, 34 offspring (group D) (C group and D group as control group). Results: The interviewed offspring was 4 to 84 months old with an average of 33.5 months. Most of the four offspring had the same height and body weight as the standard range of children of the same age. 51 cases of infants and young children were Gesell intelligence scale test, A, B group and C / D control group were detected in 17, 24, 10 cases, no case of significant mental retardation; 96 preschool children group WPPSI- R intelligence scale test, 50,30,16 cases were detected in A, B and C / D control groups respectively. The scores of language intelligence were 105 ± 20, 103 ± 21 and 115 ± 16 respectively (P = 0.119) The scores of operation intelligence were 124 ± 18, 120 ± 24 and 125 ± 17 respectively (P = 0.64). The total intelligence scores were 116 ± 18, 112 ± 23 and 122 ± 15 respectively (P = 0.303). CONCLUSIONS: There was no significant difference in the growth and intellectual development of ICSI progeny in patients with severe male infertility, such as azoospermia and severe oligozoospermia, compared with ICSI / IVF progeny of sperm or normal sperm.