Ou Jian-Ping, Zhuang Guang-Lun, Zhou Can-Quan, Wang Chang-Xi, Fang Cong, Shu Yi-Min, Zhan Qian-Sheng, Peng Wen-Lin, Zhang Min-Fang
Reproductive Medicine Research Center of First Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong 510080, China.
Zhonghua Nan Ke Xue. 2002;8(4):258-60.
To review the retrospective treatment results of the azoospermia patients during January 2001 to January 2002 in the fertility center.
One hundred males attempted intracytoplasmic sperm injection (ICSI) cycle for treatment of azoospermia. All patients were undergone sperm retrieval by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) while their wives received conventional ovarian hyperstimulation. The hormone levels, testicular histology, the rates of sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated.
Sperm were retrieved by PESA in 76 of 100 (76%) and by TESE in 23 of 100 (23%) men of azoospermia. The fertilization rate, implantation rate and clinical pregnancy rate were 71.3%, 20.35% and 42.11% respectively in PESA group, and 75.18%, 22.05% and 41.60% respectively in TESA group. Thirty-two clinical pregnancies were achieved with 15 ongoing pregnancies and subsequent live delivery for 15 cases in PESA group, and 2 cases of miscarriage, while 10 clinical pregnancies were achieved with 6 ongoing pregnancies, 2 cases of live delivery and 2 cases of miscarriage in TESA group. One case failed to retrieve sperm by TESE and canceled.
Hormonal levels and testicular histology are unable to predict which men with azoospermia will have sperm retrieved by PESA and TESE. PESA and TESE with ICSI are effective methods to treat azoospermia. There were no significant differences in fertilization, implantation and clinical pregnancy rate between two groups.
回顾2001年1月至2002年1月生育中心无精子症患者的回顾性治疗结果。
100名男性尝试通过卵胞浆内单精子注射(ICSI)周期治疗无精子症。所有患者均接受经皮附睾精子抽吸术(PESA)或睾丸精子提取术(TESE)取精,同时其妻子接受常规卵巢过度刺激。分析并评估激素水平、睾丸组织学、取精率、受精率、着床率和妊娠率。
100例无精子症男性中,76例(76%)通过PESA取到精子,23例(23%)通过TESE取到精子。PESA组的受精率、着床率和临床妊娠率分别为71.3%、20.35%和42.11%,TESE组分别为75.18%、22.05%和41.60%。PESA组有32例临床妊娠,其中15例持续妊娠,15例随后分娩,2例流产;TESE组有10例临床妊娠,其中6例持续妊娠,2例分娩,2例流产。1例通过TESE未能取到精子而取消治疗。
激素水平和睾丸组织学无法预测哪些无精子症男性能够通过PESA和TESE取到精子。PESA和TESE联合ICSI是治疗无精子症的有效方法。两组在受精率、着床率和临床妊娠率方面无显著差异。