Hultling C, Rosenlund B, Levi R, Fridström M, Sjöblom P, Hillensjö T
Department of Rehabilitation Medicine, Karolinska Institute, Stockholm, Sweden.
Hum Reprod. 1997 Mar;12(3):499-502. doi: 10.1093/humrep/12.3.499.
The objective of the present longitudinal descriptive study was to extend previous observations on the benefit of in-vitro fertilization (IVF) in cases of anejaculatory infertility due to spinal cord injuries (SCI) and to report results achieved by intracytoplasmic sperm injection (ICSI). The study was performed in a national referral unit for SCI, Spinalis SCI Research Unit, the Karolinska Institute. The patient material consisted of couples with SCI men seeking treatment for their infertility. The inclusion criteria were: stable relationship, motile spermatozoa in a diagnostic sample and no female contraindications. Spermatozoa were retrieved through electroejaculation or vibratory stimulation. If the sperm quality was judged to be sufficient, standard IVF was performed. ICSI was employed if the semen quality was extremely poor. We have treated 25 couples in 52 cycles, leading to 81 ovum retrievals and 47 embryo transfers. Total sperm counts were very variable (0.01-978 x 10(6)). Before the introduction of ICSI the fertilization rate was 30%. ICSI increased the fertilization rate to 88%. There was no association between the pregnancy rate and the sperm count, level of injury or fertilization technique. A total of 16 clinical pregnancies was established, leading to 11 deliveries. This gives a cumulative pregnancy rate per couple of 56%.
本纵向描述性研究的目的是扩展先前关于体外受精（IVF）对脊髓损伤（SCI）所致无射精症不育病例益处的观察，并报告卵胞浆内单精子注射（ICSI）所取得的结果。该研究在卡罗林斯卡学院的国家脊髓损伤转诊单位——脊髓SCI研究单位进行。患者材料包括寻求不育治疗的脊髓损伤男性夫妇。纳入标准为：关系稳定、诊断样本中有活动精子且无女性禁忌证。精子通过电射精或振动刺激获取。如果精子质量被判定足够，则进行标准体外受精。如果精液质量极差，则采用卵胞浆内单精子注射。我们在52个周期内治疗了25对夫妇，共进行了81次取卵和47次胚胎移植。精子总数差异很大（0.01 - 978×10⁶）。在引入卵胞浆内单精子注射之前，受精率为30%。卵胞浆内单精子注射将受精率提高到了88%。妊娠率与精子计数、损伤程度或受精技术之间没有关联。共确立了16例临床妊娠，分娩11例。这使得每对夫妇的累积妊娠率达到56%。
