【摘要】 目的　评价采用睾丸取精卵浆内显微注射法治疗无精症的疗效。方法　对 2 0 0 0年 7月～ 2 0 0 2年 7月来我所就诊的 35例患者 ,女方取卵当日 ,男方取精。手术时 ,患者取平卧位 ,术野常规消毒 ,用 1%利多卡因局麻 ,新鲜人体睾丸组织通过切口活检取材 ,立即放入装有培养液的培养皿中。取部分睾丸组织在体视显微镜下 ,用无菌针头划开曲精小管 ,在显微镜下检查是否存在精子。如果找到精子 ,将存有睾丸组织的培养皿放入培养箱 ,直到注射前取出。B超引导下经阴道取卵 ,常规去卵丘结构处理。在倒置显微镜下进行胞浆内单精子注射 (ICSI)。注射后 15～ 18小时检查有无原核 ,4 8小时观察卵裂 ,经阴道宫腔内移植质优胚胎 1～ 3个。移植后 11天进行妊娠试验检查 ,7周进行B超检查 ,了解有无胎心搏动。结果　35例无精症患者全部在睾丸曲精小管中找到精子。女方取卵 4 6 6个 (5～ 32个 ) ,其中MⅡ期卵 36 7个 ,显微注射 337个 ,有 2 70个受精卵见到两个原核 ,受精率为 80 11% ,35对全部获得受精卵。临床妊娠率为 4 0 %。结论　睾丸取精卵浆内显微注射技术是目前治疗无精症最有效的方法更多还原

【Abstract】 Objective To evaluate the effect of testicular sperm extraction and intracytoplasmic sperm injection(ICSI) in the management of azoospermic infertility.Methods Thirty-five adult males,aged 27-50 years and married for 2-11 years,were included in the study.After local anesthesia with 1% lidocaine and a small incision at the testis,a minute piece of testicular tissue is obtained to see whether there are aperm under a dissecting microscope.Ova are obtained through the vagina after controlled superovulation treatment with B-ultrasonographic monitoring.After removal of the cumulus oopherous a single sperm is injected into the ovum over an inverted microscope,the presence of the pronucleus is observed 15-18 hours later and cleavage 48 hour later.Seven days after the implantation of 1-3 high quality embryos,a pregnancy test is performed and 11 days later the presence of fetal heart beat is monitored with B-ultrasonography.Results In the 35 azoospermic cases,sperm are found within the seminiferous tubules.466 ova are obtained from the spouses(5-32/woman),and 367 ova are at the stage MII.ICSI are performed in 337 ova and two pronuclei are observed in 270(fertilization rate is 80.11%).All the 35 pairs obtained fertilized ova.94 embryo are implanted in the 35 women and 14 are proved by B-untrasonography to be pregnant with a pregnancy rate of 40.0%.Conclusion Testicular sperm extraction for ICSI is an effective.更多还原