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대한생식의학회지 제30권 제3호 2010년
폐쇄성 무정자증과 비폐쇄성 무정자증에서 체외수정시술 후의 임신 결과 비교
성균관대학교 의과대학 삼성제일병원 산부인과
박찬우, 궁미경,양광문,김진영,유근재,서주태,송상진,박용석,강인수,전진현
Comparative Analysis of Pregnancy Outcomes after In Vitro Fertilization with Intracytoplasmic Sperm Injection (IVF-ICSI) between Obstructive and Non-obstructive Azoospermia
Park CW
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology
Objective: To compare the pregnancy outcomes after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) between obstrucvtive and non-obstrucvtive azoospermia. Methods: From January 1994 to December 2002, 524 patients with obstructive azoospermia (886 cycles) and 163 patients with non-obstructive azoospermia (277 cycles) were included in this study. Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE) in obstructive azoospermia and TESE in non-obstructive azoospermia were perfomed to retrieve sperm, which was used for ICSI and then fertilized embryos were transferred. The results of ICSI - fertlization rate (FR), clinical pregnancy rate (CPR), clinical abortion rate (CAR) and delivery rate (DR) - were statistically analysed in obstructive versus non-obstructive azoospermia. Results: There were no differences in the number of retrieved oocytes, injected oocytes for ICSI and oocyte maturation rate. FR was significantly higher in obstructive than non-obstructive azoospermia (71.7% vs. 61.1%, p<0.001). There was no difference in CPR per embryo transfer cycle. After pregnancy was established, however, CAR was significantly higher in non-obstructive than obstructive azoospermia (25.6% vs. 12.5%, p=0.004). DR per clinical pregnancy cycle was significantly higher in obstructive than non-obstructive azoospermia (78.0% vs. 64.4%, p=0.012). In the karyotype ananlysis of abortus, abnormal karyotypes were found in 75.0% (6/8) of obstructive and 55.6% (5/9) of non-obstructive azoospermia. Conclusion: Our data show significantly higher FR in obstructive than non-obstructive azoospermia. Though there was no differrence in CPR, CAR was significantly higher in non-obstructive than obstructive azoospermia. The abortion may be related to the abnormal karyotype of embryo, but further investigations are necessary to elucidate the cause of clinical abortion in azoospermia.
키워드 : Azoospermia, TESE, Fertilization rate, Clinical pregnancy rate, Clinical abortion rate
교신저자 : junjh55@hanmail.net
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