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目的:探讨在体外受精-胚胎移植(IVF-ET)手术取卵(OPU)当天因男方偶发阴茎勃起功能障碍(ED)造成手淫取精困难的最佳处理方式。方法:回顾性分析2011年1月至2014年5月进入IVF周期偶发ED的男性患者93例,分为新鲜精液组45例(A组),提前冻精子组30例(B组),卵子冷冻组18例(C组),其中新鲜精液组又分口服药物(西地那非)组18例(A1组)和未服用药物组27例(A2组),比较各组受精率、优质胚胎率、妊娠率。结果:A组、B组、C组相比年龄、不孕年限、平均获卵数、成熟卵率、卵裂率均无统计学差异(P>0.05)。正常受精率(80.78%vs 80.43%vs 84.77%)、优质胚胎率(53.27%vs 52.97%vs 47.69%)、临床妊娠率(60.00%vs 56.77%vs 44.44%)也无统计学差异(P>0.05),C组3PN率(0.63%)明显低于A组(9.61%)和B组(4.34%)(P<0.05);新鲜精液组中A1组与A2组年龄、不孕年限、平均获卵数、成熟卵率、受精率、卵裂率、优质胚胎率、妊娠率均无统计学差异(P>0.05)。结论:IVF-ET中取卵当天偶发ED男性口服西地拉非有助于手淫取精,不影响助孕结局;对预知取精可能失败的患者可采用提前冷冻精子,取精失败者可采用冷冻卵子,但尽可能使用新鲜精液,避免睾丸附睾穿刺性损伤。
Objective: To investigate the optimal treatment of masturbation due to male occasional penile erectile dysfunction (ED) on the day of OPU in vitro fertilization and embryo transfer (IVF-ET). Methods: A retrospective analysis of 93 male patients with incidental ED in IVF from January 2011 to May 2014 was divided into 45 cases of fresh semen (group A), 30 cases of early frozen sperm (group B), egg freezing (Group C). Eighteen patients (group A1) and 27 patients (group A2) who did not take drugs were divided into fresh sperm group, oral administration group (sildenafil group), fertilization rate, quality embryo rate Pregnancy rate. Results: There was no significant difference in age, duration of infertility, average number of oocytes retrieved, mature egg rate and cleavage rate in groups A, B and C (P> 0.05). The normal fertilization rate (80.78% vs 80.43% vs 84.77%), high quality embryo rate (53.27% vs 52.97% vs 47.69%) and clinical pregnancy rate (60.00% vs 56.77% vs 44.44%) were also not significantly different (P> 0.05 ). The 3PN rate (0.63%) in group C was significantly lower than that in group A (9.61%) and group B (4.34%) (P <0.05) Number of mature egg, fertilization rate, cleavage rate, high quality embryo rate, pregnancy rate were no significant difference (P> 0.05). Conclusion: IVF-ET ovulation day occasionally ED male oral Cilazaprazole is not conducive to masturbation sperm, does not affect the outcome of pregnancy; pre-infertility may be unsuccessful in patients with premature cryogenic sperm can be used to take the wrong person can use Frozen eggs, but as far as possible the use of fresh semen to avoid testicular epididymal puncture injury.