Aytoz A, Tournaye H, Camus M, Ubaldi F, Verheyen G, Van Steirteghem A, Devroey P
Center for Reproductive Medicine, University Hospital and Medical School, Dutch-speaking Brussels Free University, Belgium.
J Assist Reprod Genet. 1998 Feb;15(2):79-83. doi: 10.1007/BF02766830.
Our purpose was to determine whether there is a need for a preliminary diagnostic laparoscopy in couples undergoing intracytoplasmic sperm injection (ICSI) because of severe male-factor infertility.
In this retrospective study, the results of diagnostic laparoscopy in 342 women with a normal fertility workup undergoing ICSI were evaluated and sperm parameters were correlated with the findings at laparoscopy. Subgroups of patients were defined according to sperm quality, which was expressed as total normal motile count [TNMC = volume (ml) x concentration (10(6)/ml) x percentage progressive motility/100 x percentage normal morphology/100].
When sperm morphology was evaluated according to Kruger's strict criteria, the probability of finding pathology on laparoscopy in the normal male group (16.7%) was statistically higher than that in the group with severely abnormal sperm (1.8%; P < 0.01).
There is no need to perform a preliminary diagnostic laparoscopy in the female partner if a full workup is normal in couples with severe male-factor infertility willing to undergo ICSI.
我们的目的是确定对于因严重男性因素不育而接受卵胞浆内单精子注射（ICSI）的夫妇，是否需要进行初步诊断性腹腔镜检查。
在这项回顾性研究中，对342名接受ICSI且生育力检查正常的女性进行诊断性腹腔镜检查的结果进行了评估，并将精子参数与腹腔镜检查结果相关联。根据精子质量定义患者亚组，精子质量用总正常活动精子数表示[TNMC = 体积（ml）×浓度（10⁶/ml）×进行性运动百分比/100×正常形态百分比/100]。
根据克鲁格严格标准评估精子形态时，正常男性组腹腔镜检查发现病理情况的概率（16.7%）在统计学上高于精子严重异常组（1.8%；P < 0.01）。
对于愿意接受ICSI的严重男性因素不育夫妇，如果女方全面检查正常，则无需对其进行初步诊断性腹腔镜检查。
