男性不育症伴成人型多囊肾患者ICSI治疗结局分析

发布时间：2018-05-10 05:52

  本文选题：成人型多囊肾 + 男性不育症　； 参考：《中华男科学杂志》2015年01期

【摘要】：目的:成人型多囊肾(ADPKD)可引起少弱精子症和无精子症,从而导致男性不育症。本文总结ADPKD致男性不育症的临床特征与治疗方案,并比较其与先天性双侧输精管缺如(CBAVD)患者的卵细胞胞质内单精子注射(ICSI)及胚胎移植(ET)治疗结局。方法:回顾性分析了2009年4月至2014年1月我中心收治的21例ADPKD不育症患者临床数据,其中15例行ICSI治疗,严格匹配164例CBAVD不育症患者,比较两组第一周期ICSI数据如夫妇双方年龄,ICSI卵子数、受精率、可移植胚胎率、优质胚胎率、胚胎种植率、生化妊娠率、临床妊娠率、早期流产率、单胎率、双胎率。结果:15例行ICSI的ADPKD不育症患者经过28个ICSI周期,10例实现临床妊娠,其中活产7例,自然流产1例,持续妊娠2例。两组患者在男、女方年龄,女方BMI,ICSI卵子数,平均移植胚胎数等基本情况差别无统计学意义(P0.05)。ADPKD不育症组与CBAVD对照组的ICSI受精率(72.64%vs76.17%)、可移植胚胎率(51.28%vs 63.24%)、优质胚胎率(38.46%vs 49.83%)、胚胎种植率(17.64%vs38.50%)、早期流产率(0%vs 9.23%)、单胎率(50%vs 81.54%)、双胎率(50%vs 18.46%)差别无统计学意义;生化妊娠率(13.33%vs 42.68%,P=0.0230.05)、临床妊娠率(13.33%vs 39.63%,P=0.0320.05)差别有统计学意义。结论:ICSI治疗ADPKD致男性不育症同样有效,但单个周期成功率较CBAVD患者低。其后代将会面临遗传风险,应在充分遗传咨询的情况下,遵从患者夫妇意愿选择治疗方案。
[Abstract]:Objective: adult polycystic kidney (ADPKD) can cause oligozoospermia and azoospermia, which leads to male infertility. This paper summarizes the clinical features and treatment of male infertility caused by ADPKD, and compares the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) in the oocytes of patients with congenital bilateral vas deferens (CBAVD). Methods: the clinical data of 21 cases of ADPKD infertility treated in our center from April 2009 to January 2014 were retrospectively analyzed. Of them, 15 cases were treated with ICSI, and 164 cases of CBAVD infertility were matched strictly. The ICSI data of the first cycle of the group were compared with the age of the couple, the number of ICSI eggs, the percentage of the ovum, the rate of embryo transfer, the rate of high quality embryo, and the implantation of the embryo. Rate, pregnancy rate, clinical pregnancy rate, early abortion rate, single fetus rate, double fetus rate. Results: 15 cases of ICSI ADPKD infertility underwent 28 ICSI cycles and 10 cases were pregnant, including 7 live births, 1 spontaneous abortion and 2 continuous pregnancy. The two groups were in male, female age, BMI, ICSI ovum, average embryo number and so on. The difference was not statistically significant (P0.05).ADPKD infertility group and CBAVD control group ICSI fertilization rate (72.64%vs76.17%), transplantable embryo rate (51.28%vs 63.24%), high quality embryo rate (38.46%vs 49.83%), embryo implantation rate (17.64%vs38.50%), early abortion rate (0% vs 9.23%), single fetus rate (50%vs 81.54%), and double fetus rate (50%vs 18.46%) had no statistical difference. Significance; the biochemical pregnancy rate (13.33%vs 42.68%, P=0.0230.05), the clinical pregnancy rate (13.33%vs 39.63%, P=0.0320.05) difference has statistical significance. Conclusion: ICSI treatment of ADPKD induced male infertility is equally effective, but the single cycle success rate is lower than that of CBAVD patients. The subsequent generation will meet the genetic risk, should comply with the full genetic counseling case, comply with the patient. The couple will choose the treatment plan.

【作者单位】： 南京医科大学第一附属医院泌尿外科;南京医科大学第一附属医院生殖医学科;
【基金】：国家卫计委卫生公益项目(201402004) 江苏省科技厅项目(BL2012009) 卫生厅项目(FXK201221)~~
【分类号】：R698.2
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本文编号：1868049