無精症病患睪丸取精後ICSI懷孕後小孩畸形率無明顯提高

無精症病患睪丸取精後ICSI懷孕後

產前基因診斷染色體異常率(7%)比一般懷孕略高

生下小孩畸形率(3-4%)無明顯提高

http://humrep.oxfordjournals.org/content/18/10/2093.full

Pregnancy outcome and neonatal data of children born after ICSI using testicular sperm in obstructive and non‐obstructive azoospermia

1. V. Vernaeve1,3, 
2. M. Bonduelle2, 
3. H. Tournaye1, 
4. M. Camus1,
5. A. Van Steirteghem1 and 
6. P. Devroey1

+Author Affiliations

1. ¹Centre For Reproductive Medicine and
2. ²Center for Medical Genetics, University Hospital, Dutch‐speaking Brussels Free University (Vrije Universiteit Brussel), Laarbeeklaan 101, B‐1090 Brussels, Belgium

1. 3To whom correspondence should be addressed. e‐mail: valerie.vernaeve@az.vub.ac.be

• Received November 16, 2002.
• Revision received May 12, 2003.
• Accepted June 18, 2003.

 

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Abstract

BACKGROUND: Registries on outcome of ICSI pregnancies obtained with testicular sperm do not differentiate between obstructive (OA) and non‐obstructive azoospermia (NOA). We evaluated the pregnancy outcome and neonatal data on children born after ICSI using testicular sperm of men with histologically proven OA or NOA. METHODS: Pregnancies obtained after ICSI using testicular sperm of men with defined NOA (n = 70) were compared with those of men with OA (n = 204). RESULTS: Multiple birth rates in NOA and OA couples, respectively, were 21 versus 27% (P = NS), overall preterm delivery rates were 38 versus 26% (NS), and prematurity rates were 24 versus 13% for singletons (NS) and 86 versus 54% for twins (relative risk 1.59, 95% confidence interval 1.04–2.42). Median gestational age for singletons was 38.3 versus 39.3 weeks, respectively (P < 0.05). The low birth weight rates were 34 versus 31%, respectively (NS). The early perinatal mortality rate was 66 versus 15 per 1000 births, respectively, (NS). Major congenital malformations were observed in 4 versus 3%, respectively, of the live born babies (NS). Prenatal karyotypes showed 7% de‐novo abnormalities in the NOA group versus 1% in the OA group (NS). CONCLUSIONS: Our data do not show differences between NOA and OA pregnancies except for a strong tendency towards a lower gestational age in singletons and a higher percentage of premature twins in the NOA group. Although our data are based on a limited sample, the differences observed call for further analysis. Given the low pregnancy rates after ICSI with NOA, a multicentre study, differentiating NOA and OA patients, would be recommended.

Key words

• Key words: azoospermia/follow‐up/ICSI/pregnancy outcome/testicular sperm

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