在TESE-ICSI周期中的生殖和产科结果:阻塞性和非阻塞性精之间的比较
Massimo Romano1,2, Federico Cirillo1,2, Noemi Ravaioli3
1Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Andrology
|December 18, 2023
概括
用细胞内注射精子 (TESE-ICSI) 进行丸精子提取显示了阻塞性精和非阻塞性精的可比生殖结果. 产科和新生儿安全性相似,尽管受精率有所不同.
科学领域:
- 生殖医学 生殖医学
- 安德罗学与人类学
- 不孕症治疗 不孕症治疗
背景情况:
- 对于使用丸精子提取 (TESE) 的细胞内注射精子 (ICSI) 循环在阻塞性亚精子和非阻塞性亚精子之间存在有限的比较数据.
- 很少有研究研究了与TESE-ICSI相关的产科和新生儿结局在这些不同的亚精子分类中.
研究的目的:
- 为了比较TESE-ICSI周期在阻塞性精子和非阻塞性精子之间的生殖结果.
- 为了确定非阻塞性阿佐精子症中受损的精子生成是否会导致不良的生殖结果,增加妊娠并发症或更高的胎儿异常率.
主要方法:
- 在2001年1月1日至2020年12月31日期间执行的TESE-ICSI周期的回顾性,单中心分析.
- 包括392对接受TESE-ICSI的夫妇,这些夫妇患有阻塞性精子缺血症 (n=620个周期) 或非阻塞性精子缺血症 (n=446个周期).
主要成果:
- 累计的交付率是相似的 (34%对31%,p=0.326).
- 在阻塞性亚精子症 (66.1%±25.7%) 中,受精率明显高于非阻塞性亚精子症 (56.1%±27.0%,p<0.001).
- 在非阻塞性亚精子症 (18.4%) 与阻塞性亚精子症 (10.7%,p=0.035) 中,母亲的并发症率更高,尽管对于个体病理而言,这些并发症在统计学上并不显著. 新生儿结局和妊娠年龄没有显著差异.
结论:
- 对于阻塞性和非阻塞性亚精子患者,TESE-ICSI提供可比的生殖成功和安全概况.
- 在非阻塞性阿佐精子症病例中,尽管精子生成受损,但产妇安全和新生儿福祉并未受到重大影响.
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