不同来源精子卵胞浆内单精子注射治疗男性不育

目的分析用3种不同来源精子行卵细胞浆内单精子注射(ICSI)治疗不育158个周期。方法女方进行常规超排卵．用射出精子。经皮附睾精子抽吸术(PEsA)或睾丸精子抽吸术(TESE)获得的精子行ICSI治疗男性不育共158个周期。结果射出精子组110个治疗周期其受精率、卵裂率、优质胚胎率、胚胎种植率和临床妊娠率为67．3％，95．2％，50．2％，20．5％和35．5％。附睾精子组38个治疗周期其受精率、卵裂率、优质胚胎率、胚胎种植率和临床妊娠率为63．5％，95．7％，60．1％，20．2％和47．4％。睾丸精子组10个治疗周期其受精率、卵裂率、优质胚胎率、胚胎种植率和临床妊娠率为68．8％，96．1％。35．1％，17．2％和30％。3组结果比较，差异无显著性意义。结论不论通过手淫取精，PESA或TESE，只要能获得活动精子，结合ICSI，各种因素的男性不育患者均有机会获得妊娠。

Intracytoplasmic sperm injectfion with different sources of sperm in treating male infertility

Objective To study 158 intracytoplasmic sperm injection (ICSI) cycles by using three different sources of sperm. Methods 158 males attempted ICSI cycle using sperm by ejaculatio, percutaneous epididymal sperm aspiration(PESA) or testicular sperm extraction(TESE) while their wives received conventional ovarian hyperstimulation. Results In the 110 cycles using ejaculation sperm group, the fertilization rate, cleavage rate, excellent embryo rate, implantation rate and clinical pregnancy rate were 67.3%,95.2%,50.2%,20.5%and 35.5%respectively.In the 38 cycles using epididymal sperm, the fertilization rate, cleavage rate, excellent embryo rate,implantation rate and clinical pregnancy rate were 63.5%,95.7%,60.1%,20.2%and 47.4%,respectively. In the 10 cycles using testitis sperm, the fertilization rate, cleavage rate, excellent embryo rate, implantation rate and clinical pregnancy rate were 68.8%,96.1%,35.1%,17.2%and 30%,respectively. The difference among the three groups were not significant. Conclusions Male infertility of different causes can be treated by ICSI using sperm from ejaculation, epididymas and testitis.