本文選題：成人型多囊腎 + 男性不育癥��； 參考：《中華男科學雜志》2015年01期

【摘要】：目的:成人型多囊腎(ADPKD)可引起少弱精子癥和無精子癥,從而導致男性不育癥。本文總結ADPKD致男性不育癥的臨床特征與治療方案,并比較其與先天性雙側輸精管缺如(CBAVD)患者的卵細胞胞質內單精子注射(ICSI)及胚胎移植(ET)治療結局。方法:回顧性分析了2009年4月至2014年1月我中心收治的21例ADPKD不育癥患者臨床數(shù)據(jù),其中15例行ICSI治療,嚴格匹配164例CBAVD不育癥患者,比較兩組第一周期ICSI數(shù)據(jù)如夫婦雙方年齡,ICSI卵子數(shù)、受精率、可移植胚胎率、優(yōu)質胚胎率、胚胎種植率、生化妊娠率、臨床妊娠率、早期流產率、單胎率、雙胎率。結果:15例行ICSI的ADPKD不育癥患者經過28個ICSI周期,10例實現(xiàn)臨床妊娠,其中活產7例,自然流產1例,持續(xù)妊娠2例。兩組患者在男、女方年齡,女方BMI,ICSI卵子數(shù),平均移植胚胎數(shù)等基本情況差別無統(tǒng)計學意義(P0.05)。ADPKD不育癥組與CBAVD對照組的ICSI受精率(72.64%vs76.17%)、可移植胚胎率(51.28%vs 63.24%)、優(yōu)質胚胎率(38.46%vs 49.83%)、胚胎種植率(17.64%vs38.50%)、早期流產率(0%vs 9.23%)、單胎率(50%vs 81.54%)、雙胎率(50%vs 18.46%)差別無統(tǒng)計學意義;生化妊娠率(13.33%vs 42.68%,P=0.0230.05)、臨床妊娠率(13.33%vs 39.63%,P=0.0320.05)差別有統(tǒng)計學意義。結論:ICSI治療ADPKD致男性不育癥同樣有效,但單個周期成功率較CBAVD患者低。其后代將會面臨遺傳風險,應在充分遺傳咨詢的情況下,遵從患者夫婦意愿選擇治療方案。
[Abstract]:Objective: adult polycystic kidney (ADPKD) can cause oligozoospermia and azoospermia, which leads to male infertility. This paper summarizes the clinical features and treatment of male infertility caused by ADPKD, and compares the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) in the oocytes of patients with congenital bilateral vas deferens (CBAVD). Methods: the clinical data of 21 cases of ADPKD infertility treated in our center from April 2009 to January 2014 were retrospectively analyzed. Of them, 15 cases were treated with ICSI, and 164 cases of CBAVD infertility were matched strictly. The ICSI data of the first cycle of the group were compared with the age of the couple, the number of ICSI eggs, the percentage of the ovum, the rate of embryo transfer, the rate of high quality embryo, and the implantation of the embryo. Rate, pregnancy rate, clinical pregnancy rate, early abortion rate, single fetus rate, double fetus rate. Results: 15 cases of ICSI ADPKD infertility underwent 28 ICSI cycles and 10 cases were pregnant, including 7 live births, 1 spontaneous abortion and 2 continuous pregnancy. The two groups were in male, female age, BMI, ICSI ovum, average embryo number and so on. The difference was not statistically significant (P0.05).ADPKD infertility group and CBAVD control group ICSI fertilization rate (72.64%vs76.17%), transplantable embryo rate (51.28%vs 63.24%), high quality embryo rate (38.46%vs 49.83%), embryo implantation rate (17.64%vs38.50%), early abortion rate (0% vs 9.23%), single fetus rate (50%vs 81.54%), and double fetus rate (50%vs 18.46%) had no statistical difference. Significance; the biochemical pregnancy rate (13.33%vs 42.68%, P=0.0230.05), the clinical pregnancy rate (13.33%vs 39.63%, P=0.0320.05) difference has statistical significance. Conclusion: ICSI treatment of ADPKD induced male infertility is equally effective, but the single cycle success rate is lower than that of CBAVD patients. The subsequent generation will meet the genetic risk, should comply with the full genetic counseling case, comply with the patient. The couple will choose the treatment plan.

【作者單位】： 南京醫(yī)科大學第一附屬醫(yī)院泌尿外科;南京醫(yī)科大學第一附屬醫(yī)院生殖醫(yī)學科;
【基金】：國家衛(wèi)計委衛(wèi)生公益項目(201402004) 江蘇省科技廳項目(BL2012009) 衛(wèi)生廳項目(FXK201221)~~
【分類號】：R698.2
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本文編號：1868049