Objective To evaluate the impact of sperm source and sperm parameters on the outcome of intracytoplasmic sperm injection (ICSI). Methods This retrospective study included 433 ICSI cycles from June 2005 to December 2008 in Reproductive Medical Center of Xiangya Hospital. The patients were divided into 2 major groups according to the source of spermatozoa used for ICSI: ejaculated ( group A, n = 336 ) and epididymal ( group B, n = 97 ). Group A was divided into 3 subgroups according to the sperm parameters: normal ( Group Al, n = 95 ), single parameter defect (Group A2,n = 119), and multiple parameter defect (Group A3,n = 122). Results The basic characteristics among the 4 groups had no statistic difference ( P ＞ 0.05 ), and the difference in the fertilization rate, normal fertilization rate, cleaving embryo rate, good quality embryo rate, implanted rate, clinical pregnancy rate, and early abortion rate among the 4 groups were not significant (P ＞0.05). Conclusion The outcome is similar no matter whether the spermatozoa is from ejaculated sperm or epididymis. ICSI can treat male infertility of various factors, and the outcome is the same with one or multiple sperm parameter abnormality. ICSI with epididymal spermatozoa through percutaneous epididymal sperm aspiration is effective for infertility due to obstructive azoospermia.%目的:探讨不同源性精子、不同参数精子对卵胞浆内单精子注射术(intracytoplasmic sperm injection, ICSI)结局的影响.方法:回顾性分析2005年6月至2008年12月在中南大学湘雅医院生殖医学中心接受ICSI治疗的433个周期.根据行ICSI的精子来源,分为射出精子组(A组)336个周期,附睾来源精子组(B组)97个周期.根据精子参数,又将射出精子组分为3个亚组,即正常组(A1组)95个周期,单参数异常组(A2组)119个周期,多参数异常组(A3组)122个周期.比较4组的受精率、正常受精率、卵裂率、优胚率、胚胎种植率、临床妊娠率、早期流产率.结果:4组的一般情况比较,差异无统计学意义(P＞0.05).4组的受精率、正常受精率、卵裂率、优胚率、胚胎种植率、临床妊娠率、早期流产率比较,差异无统计学意义(P＞0.05).结论:精子无论是来自附睾还是射出精液,对其ICSI结局无影响;ICSI可以治疗各种因素的男性不育,单一或多种参数异常精子不影响ICSI结局;经皮附睾抽吸精子行ICSI是治疗梗阻性无精子症所致的男性不育的有效方法.
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