本文選題：活精子細胞器形態(tài)學(xué)檢測 + 卵母細胞漿內(nèi)單精子注射��； 參考：《南方醫(yī)科大學(xué)學(xué)報》2015年10期

【摘要】：目的使用放大系統(tǒng)對不育男性患者的精子進行形態(tài)選擇性卵母細胞漿內(nèi)單精子注射術(shù)(IMSI),觀察IMSI技術(shù)能否改善因男性精液問題而不孕不育夫婦的助孕結(jié)局。方法回顧分析本中心2013年1月~2014年11月共82例梗阻性無精子癥患者,將行TESA(經(jīng)皮睪丸穿刺抽吸精子術(shù))獲得的睪丸精子通過放大系統(tǒng)(×6600)挑選后行卵母細胞注射(IMSI組),2013年1月~2014年11月共91例梗阻性無精子癥患者經(jīng)TESA取精術(shù)后行常規(guī)卵母細胞漿內(nèi)單精子注射(ICSI組);2014年1月~11月共44例畸精子癥患者行形態(tài)選擇性包漿內(nèi)單精子注射治療(IMSI組),2014年1月~11月共71例畸精子癥患者行常規(guī)ICSI治療(ICSI組)。統(tǒng)計分析ICSI組和IMSI組患者的實驗室結(jié)局和臨床結(jié)局。結(jié)果梗阻性無精子癥患者中正常受精率IMSI組顯著高于ICSI組(84.3%vs 77.0%)(P0.05);ICSI組的卵裂率95.5%,優(yōu)胚率28.2%,囊胚形成率54.8%,種植率26.4%,臨床妊娠率47.3%,流產(chǎn)率14%,梗阻性無精子癥IMSI組患者的卵裂率96.7%,優(yōu)胚率29.2%,囊胚形成率54.3%,種植率32.3%,臨床妊娠率50.0%,流產(chǎn)率7.3%,兩組無顯著性差異(P0.05)。畸精子癥患者的正常受精率IMSI組顯著高于ICSI組(68%vs 75.5%)(P0.05),囊胚形成率IMSI組顯著高于ICSI組(54.6%vs 67.9%)(P0.05),ICSI組的卵裂率96.2%,優(yōu)胚率27.6%,種植率28.2%,臨床妊娠率43.7%,流產(chǎn)率9.7%;IMSI組患者的卵裂率95.2%,優(yōu)胚率27.1%,種植率30.7%,臨床妊娠率43.2%,流產(chǎn)率10.5%,兩組無顯著性差異(P0.05)。結(jié)論梗阻性無精子癥患者的睪丸精子經(jīng)放大系統(tǒng)選擇后行ICSI,正常受精率較傳統(tǒng)ICSI有顯著性提高;畸精子癥患者射出的精液標本經(jīng)放大系統(tǒng)挑選后行ICSI,正常受精率、囊胚形成率較傳統(tǒng)ICSI有顯著性提高。
[Abstract]:Objective to investigate whether IMSI technique can improve the outcome of assisted pregnancy in infertile couples due to male semen problems by using an amplification system to perform morphoselective intracytoplasmic sperm injection (IMSI) in infertile men. Methods 82 patients with obstructive azoospermia from January 2013 to November 2014 were retrospectively analyzed. Testicular spermatozoa obtained by percutaneous testicular aspiration was selected by amplification system (脳 6600) and then oocytes were injected with oocytes. From January 2013 to November 2014, 91 patients with obstructive azoospermia were treated with conventional sperm extraction via TESA. From January to November 2014, 44 patients with teratospermia were treated with morphological selective intracytoplasmic sperm injection, and 71 patients with teratospermia were treated with conventional ICSI from January to November 2014. The laboratory and clinical outcomes of patients with ICSI and IMSI were statistically analyzed. Results the normal fertilization rate in patients with obstructive azoospermia in IMSI group was significantly higher than that in ICSI group (84.3 vs 77.0). The cleavage rate was 95.5%, the excellent embryo rate was 28.2, the blastocyst formation rate was 54.8%, the implantation rate was 26.4%, the clinical pregnancy rate was 47.3%, the abortion rate was 14.3%, and the egg size of the IMSI group with obstructive azoospermia was 144.3%. The cleavage rate was 96. 7%, the excellent embryo rate was 29. 2%, the blastocyst rate was 54. 3%, the implantation rate was 32. 3%, the clinical pregnancy rate was 50. 0%, and the abortion rate was 7. 3. There was no significant difference between the two groups (P 0. 05). The normal fertilization rate in IMSI group was significantly higher than that in ICSI group (P 0.05), the blastocyst formation rate in IMSI group was significantly higher than that in ICSI group (54.6% vs 67.9%), the cleavage rate was 96.26.20%, the embryo rate was 27.6%, the implantation rate was 28.2%, the clinical pregnancy rate was 43.7%, the abortion rate was 9.7m and the cleavage rate of IMSI group was 95.25.00%. The embryo rate was 27.1%, the planting rate was 30.7%, the clinical pregnancy rate was 43.2%, the abortion rate was 10.5%, there was no significant difference between the two groups (P 0.05). Conclusion the normal fertilization rate of testicular spermatozoa of patients with obstructive azoospermia was significantly higher than that of traditional ICSI, and the normal fertilization rate of sperm samples from patients with teratospermia was determined by amplification system. Blastocyst formation rate was significantly higher than that of traditional ICSI.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院婦產(chǎn)科生殖醫(yī)學(xué)中心;四川省成都市錦江區(qū)婦幼保健院生殖醫(yī)學(xué)中心;南方醫(yī)科大學(xué)遺傳教研室;
【基金】：四川省科學(xué)廳基礎(chǔ)醫(yī)學(xué)研究項目(2012JY0066) 廣東省科技計劃項目(2013B0022000017) 南方醫(yī)科大學(xué)南方醫(yī)院院長基金(2013C026)
【分類號】：R714.8

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