Hernández Ayup Samuel, Balderas Rosales Claudia del R, Saucedo de la Llata Eric, Moraga María Rosa, Batiza Reséndiz Víctor, Santos Haliscak Roberto, Galache Vega Pedro
Instituto para el Estudio de la Concepción Humana (IECH), Monterrey, NL.
Ginecol Obstet Mex. 2005 Feb;73(2):69-75.
The intacytoplasmic sperm injection (ICSI) is the assisted reproduction technique (ART) that currently offers satisfactory results to infertile couples. The use of epididymal surgical retrieval (percutanean epydidimal sperm aspiration: PESA) and testicular sperm retrieval (testicular sperm extraction: TESE) combined with ICSI has come to bring a high response to azoospermic male.
To communicate the results obtained from the Institute for the Study of Human Conception, in Monterrey, NL, with the application of the ICSI technique with ejaculate sperm and in azoospermic patients using sperm obtained from PESAor by testicular sperm extraction TESE.
From January 1999 to December 2003 1,436 couples were studied at the Institute for the Study of Human Conception, Monterrey, Mexico; 729 cases underwent to ICSI (50.8%), 670 used the ejaculate sperm, in 37 cases (5%) PESA and 22 cases (3%) TESE. These patients were treated as usual: controlled ovarian hyperstimulation (COH) with FSHr alone or combined with HMG or LHr, use of GnRH analogs (agonist o antagonist), follicular monitoring up to the presence of 3 follicles longer than 18 mm; ovular retrieval 34 h after HGC application and embryo transfer in days 3 or 5 of development.
No statistically significant difference was noted in the woman's age (p = 0.623), type and time of sterility (p = 0.446, 0.150), neither in FSH, LH and estradiol levels (p = 0.549, 0.623, 0.685). The middle age of the male had significant difference between PESA (38.9 +/- 7.3) and ejaculated sperm (36.1 +/- 6.4) (p = 0-024). The pregnancy rates among groups of the ejaculate sperm, PESA and TESE were 32.8%, 43.2% and 40.9% respectively, without significant difference (p = 0.327), neither in implantation rates: 11.2%, 26% and 11%, respectively (p = 0.153).
The technique of ICSI and use of PESA and TESE offer satisfactory results in infertile couples, including azoospermic male.
胞浆内单精子注射（ICSI）是目前为不孕夫妇提供满意结果的辅助生殖技术（ART）。附睾手术取精（经皮附睾精子抽吸术：PESA）和睾丸取精（睾丸精子提取术：TESE）联合ICSI的应用已为无精子症男性带来了较高的成功率。
报告墨西哥新莱昂州蒙特雷人类受孕研究所应用ICSI技术使用射出精子以及在无精子症患者中使用从PESA或通过TESE获得的精子所取得的结果。
1999年1月至2003年12月，墨西哥蒙特雷人类受孕研究所对1436对夫妇进行了研究；729例接受了ICSI治疗（50.8%），670例使用射出精子，37例（5%）采用PESA，22例（3%）采用TESE。这些患者按常规治疗：单独使用促卵泡激素受体激动剂（FSHr）或联合人绝经期促性腺激素（HMG）或促黄体生成素受体激动剂（LHr）进行控制性卵巢过度刺激（COH），使用促性腺激素释放激素类似物（激动剂或拮抗剂），监测卵泡直至有3个卵泡直径大于18mm；注射人绒毛膜促性腺激素（hCG）后34小时取卵，并在胚胎发育的第3天或第5天进行胚胎移植。
在女性年龄（p = 0.623）、不孕类型和时间（p = 0.446，0.150）方面未发现统计学显著差异，促卵泡生成素（FSH）、促黄体生成素（LH）和雌二醇水平也无差异（p = 0.549，0.623，0.685）。PESA组男性的平均年龄（38.9±7.3）与射出精子组（36.1±6.4）之间存在显著差异（p = 0.024）。射出精子组、PESA组和TESE组的妊娠率分别为32.8%、43.2%和40.9%，无显著差异（p = 0.327），着床率也无差异：分别为11.2%、26%和11%（p = 0.153）。
ICSI技术以及PESA和TESE的应用为不孕夫妇，包括无精子症男性，提供了满意的结果。
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