De Croo I, Van der Elst J, Everaert K, De Sutter P, Dhont M
Infertility Centre, Department of Obstetrics and Gynaecolog, University Hospital of Ghent, Belgium.
Hum Reprod. 2000 Jun;15(6):1383-8. doi: 10.1093/humrep/15.6.1383.
The aetiology of azoospermia can be grossly divided into obstructive and non-obstructive causes. Although in both cases testicular spermatozoa can be used to treat male fertility, it is not well established whether success rates following intracytoplasmic sperm injection (ICSI) are comparable. Therefore, a retrospective analysis of fertilization, pregnancy and embryo implantation rates was performed following ICSI with testicular spermatozoa in obstructive or non-obstructive azoospermia. In total, 193 ICSI cycles were carried out with freshly retrieved testicular spermatozoa; in 139 cases of obstructive and 54 cases of non-obstructive azoospermia. The fertilization rate after ICSI with testicular spermatozoa in non-obstructive azoospermia was significantly lower than in obstructive azoospermia (67.8% versus 74.5%; P = 0.0167). Within the non-obstructive group, the fertilization rate in the group of maturation arrest (47.0%) was significantly lower than in case of Sertoli cell-only (SCO) syndrome (71.2%) or germ cell hypoplasia (79. 5%). Embryo quality on day 2 after ICSI was similar for all groups. Pregnancy rates per transfer between obstructive (36.8%) and non-obstructive groups (36.7%) were similar. In cases of maturation arrest the pregnancy rate per transfer was lowest (20.0%) although not significantly different from SCO syndrome or hypoplasia groups. Embryo implantation rates were not different between the obstructive (19.6%) and non-obstructive groups (25.8%), and were lowest in cases of germ cell hypoplasia (15.8%). This retrospective analysis shows that although fertilization rate after ICSI with testicular spermatozoa in non-obstructive azoospermia is significantly lower than in obstructive azoospermia, pregnancy and embryo implantation rates are similar.
无精子症的病因大致可分为梗阻性和非梗阻性原因。虽然在这两种情况下,睾丸精子都可用于治疗男性不育症,但卵胞浆内单精子注射(ICSI)后的成功率是否可比尚未明确。因此,对梗阻性或非梗阻性无精子症患者采用睾丸精子进行ICSI后的受精、妊娠及胚胎着床率进行了回顾性分析。总共进行了193个使用新鲜获取的睾丸精子的ICSI周期;其中梗阻性无精子症139例,非梗阻性无精子症54例。非梗阻性无精子症患者采用睾丸精子进行ICSI后的受精率显著低于梗阻性无精子症患者(67.8%对74.5%;P = 0.0167)。在非梗阻性组中,成熟停滞组的受精率(47.0%)显著低于唯支持细胞(SCO)综合征组(71.2%)或生殖细胞发育不全组(79.5%)。ICSI后第2天各组的胚胎质量相似。梗阻性组(36.8%)和非梗阻性组(36.7%)每次移植的妊娠率相似。在成熟停滞病例中,每次移植的妊娠率最低(20.0%),尽管与SCO综合征组或发育不全组无显著差异。梗阻性组(19.6%)和非梗阻性组(25.8%)的胚胎着床率无差异,生殖细胞发育不全病例的胚胎着床率最低(15.8%)。这项回顾性分析表明,虽然非梗阻性无精子症患者采用睾丸精子进行ICSI后的受精率显著低于梗阻性无精子症患者,但妊娠率和胚胎着床率相似。