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目的探讨应用睾丸细针穿刺(TEFNA)在非阻塞性无精子症患者获取成熟精子,结合ICSI治疗男性不育。方法用23号蝶型针与20ml注射器相连,注射器固定于保持其负压的手柄上,平均每个睾丸穿刺15针。结果57%(69/121)的患者,56.3%(99/176)个周期获得成熟精子,经睾丸组织学检查不同类型患者的精子获取率分别为:唯支持细胞46.7%(21/45),精子成熟障碍45.7%(16/35),精子发生低下96.1%(25/26),非嵌合型Klinefelter综合征63.6%(7/11),3例放疗后睾丸纤维化及1例单侧睾丸癌切除化疗后未获得精子。在仅注射了丈夫精子的87个周期中,591个卵细胞行精子注射,其中36.9%(218/591)受精,得到202个胚胎,其62个周期移值了178个胚胎(每个周期平均为2.831.7个胚胎),得到26例临床妊娠(共有44个妊娠囊),妊娠率为41.9%,种植率为24.7%,结论TEFNA结合ICIS是一种简易、安全、有效、易被患者接受的治疗非阻塞性无精子症的方法。
Objective To investigate the application of TEFNA in the acquisition of mature sperm in patients with non-obstructive azoospermia and male infertility combined with ICSI. Method with a No. 23 butterfly needle and 20ml syringe connected to the syringe fixed to maintain its negative pressure on the handle, the average testicular puncture 15. Results In 57% (69/121) of the patients, mature sperm were obtained in 56.3% (99/176) cycles. The sperm retrieval rates in different types of testis were 46.7% (21/45) 45.7% (16/35) had sperm maturation disorder, 96.1% (25/26) had low spermatogenesis, 63.6% (7/11) had non-chimeric Klinefelter syndrome, 3 had testicular fibrosis after radiotherapy and 1 had unilateral testicular Cancer excision did not obtain sperm after chemotherapy. Of 87 cycles injected with only husband sperm, 591 oocytes were sperm injected, 36.9% (218/591) were fertilized, 202 embryos were obtained, and 62 cycles shifted 178 embryos (average of each cycle was 2.831.7 embryos), 26 cases of clinical pregnancy (a total of 44 gestational sac), the pregnancy rate was 41.9%, the implantation rate was 24.7%, Conclusion TEFNA combined with ICIS is a simple, safe, effective and easy to be accepted by patients Methods of treating non-obstructive azoospermia.