不孕不育症的治疗.pptx
不孕不育症的治疗
;
Thehigh-possibilityfertilephaseextends
from5daysbeforeovulationtothedayof;
Criteria;
AssistedReproductiveTechniques
?Intra-UterineInsemination(IUI)
–ArtificialInseminationwithHusband(AIH)
–ArtificialInseminationwithDonor(AID)
?Gameteintra-fallopiantransfer(GIFT)
?Zygoteintra-fallopiantransfer(ZIFT)
?Invitrofertilization(IVF)
?Intracytoplasmicsperminjection(ICSI)
?Pre-implantationgeneticdiagnosis(PGD);
IUI,配偶人工授孕(AIH)
*(一)适应症:男性精虫稀少(每西西一千万左右),尿道下裂、阴茎畸型、阳萎、早泄、女性阴道痉挛不能性交、配偶常出差等。
*(二)方法:男性将精液取出,经液化后 ,将精虫洗涤,去除精液之杂质,在女性排卵期将精液注入子宫腔。
2014/4/24;
图片来源:我省生殖医学会网站;
MaleFactorInfertility
?BestresultswithIUIareachievedwhen
Totalmotilespermcount(TMC)inthe
inseminationspecimenexceeds10million14%ormorehavenormalmorphology
?Highercountsdonotincreasesuccess
?IUIisseldomsuccessfuliffewerthan1milliontotalmotilespermarepresent
.;
黄X玉陈Xj;
2014/4/24;
MaleFactorInfertility
?TMC1million:ICSI
?TMC1and10million:
IVFcanbeperformedifinfertilityduration
is2yearsorlonger
?TMC10million:IVFisindicatedifthe
durationis3yearsorlonger.Ifthewoman
isolderthan36years,IVFmaybe
consideredearlier
.;
体外授精(试管婴儿)IVF
*(一)适应症:骨盆腔粘连、输卵管堵塞、输卵管切除、严重度子宫内膜异位、精子稀少(五百万左右)、精虫产生抗体等。
*(二)方法:
*(1)用排卵物诱导排卵
(2)利用超音波检查卵泡及抽血测E2
(3)当卵子成熟,利用阴道超音波,将卵子取出(4)在实验室将精子与卵子完成受精分裂成胚胎,再植入子宫腔
2014/4/24;
精虫显微注射:(ICSI)
应用在合并男性不孕或先前尝试受精率低者;
IntraCytoplasmicSpermInjection;
MaleFactorInfertility
?IndicationsforICSI
Totalmotilespermcount1million
4%normalmorphologyandTMC5
million
NoorpoorfertilizationinthefirstIVFcycle
whenTMC10million
NoorpoorfertilizationintwoIVFcycles
whenTMC10million
Epididymalortesticularspermatozoa
.;
精卵显微授精法(microinjection)
(一)适应症:
(1)严重精虫稀少(在一百万只左右)、精虫活动力差、IVF不能受精者。
(2)精液检查无精子,但睪丸组织有精子,请泌尿外科大夫,将精子吸出在实验室处理。
*(二)方法:
在显微镜下,将一只精子注射入卵子,因注射部位不同,可分为
(A)透明层下注射法(su