尿促性腺素与绒促性腺素联合应用在不明原因非梗阻性无精子症治疗中的扳机作用

发布时间：2018-09-13 07:13

【摘要】：目的:探索尿促性腺素(HMG)联合绒促性腺素(hCG)的扳机作用对于不明原因的非梗阻性无精子症患者的治疗是否有效。方法:回顾性分析2010年1月至2017年5月间在贵州省妇幼保健院就诊的282例不明原因的非梗阻性无精子症患者资料,扳机治疗方法为每例患者第1周和第2周进行HMG每次75 IU肌肉注射,每周3次。第3周和第4周hCG每次2 000 IU肌肉注射,每周2次,并结合维生素E、左卡尼汀、他莫昔芬口服辅助治疗,治疗3个月至1年。结果:接受治疗的282例非梗阻性无精子症患者,27例未完成治疗而失访,完成治疗的255例患者治疗后精液中发现有精子的58例,均为严重少弱精子症,其中47例接受辅助生殖技术助孕,2例失访,女方获得临床妊娠18例;其余197例治疗后精液检查中未发现有精子,其中25例行附睾或睾丸穿刺活检,有6例发现精子,均接受辅助生殖助孕,女方获得临床妊娠3例。共64例精液中或附睾、睾丸穿刺发现精子,有效率25.1%。结论:HMG联合hCG药物扳机治疗结合口服药物辅助治疗对不明原因的非梗阻性无精子症有一定效果。
[Abstract]:Aim: to investigate the efficacy of (HMG) combined with chorionic gonadotropin (hCG) in the treatment of unexplained non-obstructive azoospermia. Methods: the data of 282 patients with non-obstructive azoospermia from January 2010 to May 2017 in Guizhou Provincial Maternal and Child Health Hospital were retrospectively analyzed. Trigger therapy was performed by 75 IU intramuscular injection of HMG at week 1 and week 2 in each patient, three times a week. At week 3 and week 4, hCG was injected intramuscularly with 2 000 IU twice a week, combined with vitamin E, levacarnitine and tamoxifen oral adjuvant therapy for 3 months to 1 year. Results: 282 patients with non-obstructive azoospermia received treatment and 27 patients lost their spermatozoa without complete treatment. After treatment, 58 patients with spermatozoa were found to have spermatozoa, all of them were severe oligozoospermia. Among them, 47 cases received assisted reproductive technique and 2 cases lost pregnancy, 18 cases were clinically pregnant, the remaining 197 cases did not find sperm in semen examination after treatment, 25 cases received epididymal or testicular puncture biopsy, and 6 cases found spermatozoa. All of them received assisted reproductive aid, and 3 cases of clinical pregnancy were obtained. In 64 cases of semen or epididymis, spermatozoa were found by testicular puncture, the effective rate was 25.1g. Conclusion the combination of hCG and hCG combined with oral drug adjuvant therapy has certain effect on non-obstructive azoospermia with unknown cause.
【作者单位】：贵州省妇幼保健院(贵阳市妇幼保健院)辅助生殖科;中信湘雅生殖与遗传专科医院精子库;
【基金】：贵州省科技计划项目(黔科合LH字[2014]7312号)~~
【分类号】：R698.2

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