In Vitro Fertilization Unit, Sheba Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Fertil Steril. 2012 May;97(5):1056-60. doi: 10.1016/j.fertnstert.2012.01.129. Epub 2012 Feb 24.
To evaluate sperm quality and fertility potential of men with psychogenic anejaculation treated by electroejaculation (EEJ) and intracytoplasmic sperm injection (ICSI). Treatment results were compared to spinal cord injured (SCI) patients treated similarly.
Retrospective clinical study.
Academic tertiary referral fertility center.
PATIENT(S): Couples with isolated psychogenic anejaculation or SCI.
INTERVENTION(S): Electroejaculation and ICSI.
MAIN OUTCOME MEASURE(S): Semen analysis, fertilization rate, implantation rate, pregnancy rate, delivery rate and safety of the procedure.
RESULT(S): Fifteen patients diagnosed with psychogenic anejaculation underwent 40 EEJ/ICSI cycles. The semen retrieved was characterized by low motility (mean 10.7% ± 12.3%), normal volume (2.2 ± 1.9 mL) and normal count (25.1 ± 29.9 × 10(6)/mL), according to World Health Organization criteria. Results of EEJ/ICSI were compared with 22 SCI patients treated by 66 EEJ/ICSI cycles during the same period. Mean female age and the number of oocytes retrieved per cycle were similar between the groups. Similar semen parameters after EEJ were found between psychogenic and SCI patients. Fertilization rate was significantly lower in the psychogenic patients compared to SCI (47.0% and 57.0%, respectively). No significant differences were found regarding pregnancy rates (20% and 22.7%, respectively), implantation rate (10.2% and 11.6%, respectively) or delivery rates (15% and 18.2%, respectively).
CONCLUSION(S): Sperm retrieved by EEJ is characterized by asthenospermia and normal count. In spite of the lower fertilization rate in psychogenic patients, combination of EEJ and ICSI gives adequate results to couples with psychogenic anejaculation similar to the results obtained for SCI patients. Current results give these couples a reasonable chance of pregnancy achievement.
评估电刺激射精（EEJ）和卵胞浆内单精子注射（ICSI）治疗精神性不射精症患者的精子质量和生育潜能。将治疗结果与接受类似治疗的脊髓损伤（SCI）患者进行比较。
回顾性临床研究。
学术型三级转诊生育中心。
患有孤立性精神性不射精或 SCI 的夫妇。
EEJ 和 ICSI。
精液分析、受精率、着床率、妊娠率、分娩率和手术安全性。
15 例被诊断为精神性不射精症的患者接受了 40 次 EEJ/ICSI 周期。根据世界卫生组织标准，所获得的精液特征为低活力（平均 10.7%±12.3%）、正常体积（2.2±1.9mL）和正常计数（25.1±29.9×10⁶/mL）。EEJ/ICSI 的结果与同期接受 66 次 EEJ/ICSI 周期治疗的 22 例 SCI 患者进行了比较。两组女性年龄和每周期采集的卵母细胞数相似。精神性和 SCI 患者 EEJ 后精液参数相似。与 SCI 患者相比，精神性患者的受精率显著降低（分别为 47.0%和 57.0%）。两组妊娠率（分别为 20%和 22.7%）、着床率（分别为 10.2%和 11.6%）或分娩率（分别为 15%和 18.2%）均无显著差异。
EEJ 获得的精子表现为弱精症和正常计数。尽管精神性患者的受精率较低，但 EEJ 和 ICSI 的联合应用为精神性不射精症患者提供了与 SCI 患者相似的充足结果。目前的结果使这些夫妇有合理的机会实现妊娠。
