Kumbak Banu, Akbas Hande, Karlikaya Guvenc, Karagozoglu Hale, Ozkan Semih, Kahraman Semra
Department of Obstetrics and Gynecology, Yeditepe University Hospital, Istanbul, Turkey.
J Reprod Med. 2009 Nov-Dec;54(11-12):691-7.
To evaluate the outcome in couples composed of azoospermia and a poor responder female undergoing assisted reproductive techniques (ARTs).
A retrospective study was performed involving 97 men suffering from nonobstructive azoospermia (NOA) whose partners had a poor response to ovarian stimulation. Poor response was defined as retrieval of fewer than 5 oocytes. Main outcome measures were implantation rate (IR), clinical pregnancy rate per embryo transfer (CPR/ET) and early pregnancy loss rate (EPLR).
Overall IR, CPR/ET and EPLR were found to be 16%, 23% and 15%, respectively, which were significantly lower than those in NOA men with normoresponder partners except EPLR (25%, 52% and 24%, respectively). When the results were further stratified according to number of oocytes retrieved and body mass index, no significant difference was observed between the groups. However, when the results were analyzed according to the woman's age, a significantly lower CPR/ ET was found in poor responder women aged > or = 38 years (11% vs. 33%; p = 0.03).
Although success of ART is suggested to be high once motil spermatozoa are found in testicular sperm extraction in NOA cases, poor response to ovarian stimulation might be considered as one of the strongest determinants of the outcome.
评估由无精子症男性和卵巢低反应女性组成的夫妇接受辅助生殖技术（ART）的结局。
进行了一项回顾性研究，纳入97名患有非梗阻性无精子症（NOA）且其伴侣对卵巢刺激反应不良的男性。卵巢低反应定义为获取的卵母细胞少于5个。主要结局指标为着床率（IR）、每次胚胎移植的临床妊娠率（CPR/ET）和早期妊娠丢失率（EPLR）。
总体IR、CPR/ET和EPLR分别为16%、23%和15%，除EPLR外（分别为25%、52%和24%），均显著低于伴侣反应正常的NOA男性。当根据获取的卵母细胞数量和体重指数对结果进行进一步分层时，各亚组之间未观察到显著差异。然而，当根据女性年龄分析结果时，年龄≥38岁的卵巢低反应女性的CPR/ET显著较低（11%对33%；p=0.03）。
尽管在NOA病例中，一旦在睾丸精子提取中发现活动精子，ART的成功率被认为较高，但对卵巢刺激的低反应可能被视为结局最有力的决定因素之一。
