本文選題：不明原因不孕　切入點(diǎn)：精子　出處：《中華男科學(xué)雜志》2017年02期 　論文類(lèi)型：期刊論文

【摘要】：目的:探討精子頂體酶檢測(cè)對(duì)不明原因不孕(UI)夫婦選擇助孕治療方案的臨床意義。方法:回顧性分析2013年1月至2015年12月診斷為UI,并經(jīng)3次宮腔內(nèi)人工授精(IUI)治療失敗改行體外受精-胚胎移植(IVF-ET)助孕的49對(duì)夫婦共49個(gè)周期的臨床資料,并對(duì)比分析同期因輸卵管阻塞因素行常規(guī)IVF治療的95對(duì)夫婦的131個(gè)周期的臨床資料,比較兩組實(shí)驗(yàn)室數(shù)據(jù)、臨床結(jié)局和頂體酶活性差異;進(jìn)一步根據(jù)UI夫婦男方精子頂體酶活性將UI組分成2個(gè)亞組:36 IU/106精子組共20個(gè)周期,≥36 IU/106精子組共29個(gè)周期,比較兩亞組之間受精率的差異。結(jié)果:1行IVF-ET治療的UI夫婦,比同期因輸卵管阻塞行常規(guī)IVF的夫婦受精率顯著下降(67.0%vs 76.4%,P0.05),補(bǔ)救性卵細(xì)胞胞質(zhì)內(nèi)單精子注射(ICSI)率高于輸卵管因素組(20.4%vs 6.1%,P0.05);成熟卵母細(xì)胞比例(MII卵率)、可利用胚胎率、優(yōu)胚率、種植率、臨床妊娠率兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2UI組中位精子頂體酶活性低于輸卵管因素組(36.03 IU/106精子vs 61.98 IU/106精子,P0.01),UI組中頂體酶活性36 IU/106精子亞組的受精率明顯低于頂體酶活性≥36 IU/106精子亞組的受精率(47.7%vs80.3%,P0.01)。結(jié)論:1UI夫婦男方精子頂體酶活性低下導(dǎo)致的受精率低,可能是造成女性不孕的主要原因和潛在因素。2鑒于UI夫婦男方精子頂體酶活性36 IU/106精子時(shí)受精率較低,建議不采用IUI治療,可選擇IVF+短時(shí)受精聯(lián)合早期補(bǔ)救ICSI治療。
[Abstract]:Objective: to investigate the clinical significance of sperm acrosin detection in the choice of assisted pregnancy therapy for couples with unexplained infertility. Methods: the diagnosis of UI from January 2013 to December 2015 was retrospectively analyzed and treated by intrauterine artificial insemination with IUI 3 times. Clinical data of 49 couples with IVF-ET-assisted pregnancy in 49 cycles. The clinical data of 131 cycles of 95 couples who received routine IVF therapy due to tubal obstruction were analyzed, and the clinical data, clinical outcome and acrosin activity were compared between the two groups. The UI group was further divided into 2 subgroups: 36 IU/106 sperm group for 20 cycles and 鈮，

本文編號(hào)：1633151