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目的比较先天性双侧输精管缺如(CBAVD)、精索静脉曲张(VC)、AZFc 缺失这三种病因与相应对照周期卵胞浆内单精子注射(ICSI)治疗的结局.方法比较 CBAVD 组与非 CBAVD 的梗阻性无精子症(non-CBAVD 组),VC 组与非 VC 的严重少、弱精子症(non-VC 组),AZFc 缺失与非 AZFc 缺失的严重少弱精子症(non-AZFc 组)行 ICSI 治疗的受精率、卵裂率、优质胚胎率、累积妊娠率以及其他相关指标.结果各组间的女方年龄差异无统计学意义.CBAVD 组与 non-CBAVD 组比较,受精率为61.36% vs 57.02%(P >0.05),卵裂率100% vs 99.61%(P >0.05),优质胚胎率26.67% vs 48.24%(P 0.05),优质胚胎率40.40% vs 38.79%(P >0.05),累积妊娠率60.00% vs 55.56%(P >0.05),VC 组受精率低于 non-VC 组,差异无统计学意义.AZFc 组与 non-AZFc 组相比,受精率为57.14% vs 64.92%(P >0.05),卵裂率100% vs 99.36%(P >0.05),优质胚胎率36.36% vs 41.33%(P >0.05),累积妊娠率66.67% vs 53.70%(P >0.05),差异均无统计学意义.结论 CBAVD 男性 ICSI 优质胚胎率和累积妊娠率降低,VC 和AZFc 缺失对 ICSI 受精率、卵裂率、优质胚胎率和累积妊娠率无明显影响.“,”Objective To compare the ICSI treatment outcomes of congenital bilateral absence of the vas deferens, varicocele and AZFc microdeletion with corresponding control cycles. Methods The ICSI fertilization rate, cleavage rate, good quality embryo rate, cumulative pregnancy rate and other relevant parameters were comparatively analyzed between congenital bilateral absence of the vas deferens (CBAVD group) and non-CBAVD obstructive azoospermia (non-CBAVD group), varicocele (VC group) and non- varicocele serious oligoasthenospermia (non- VC group), AZFc microdeletion and non-AZFc microdeletion serious oligoasthenospermia (non-AZFc group). Results There was no significant difference in the age of female among groups. Fertilization rates of the CBAVD group and the non-CBAVD group were 61.36% and 57.02% respectively(P> 0.05), cleavage rate were 100% and 99.61%(P> 0.05), good quality embryo rate were26.67% and 48.24% (P 0.05), good quality embryo rate (40.40% vs 38.79% , P>0.05), and cumulative pregnancy rate( 60.00% vs 55.56%, P >0.05). The VC group had lower fertilization rate, with no statistical differences. There were no statistical differences between AZFc group and non-AZFc group in fertilization rate (57.14% vs 64.92%, P> 0.05), cleavage rate (100% vs 99.36%, P> 0.05), good quality embryo rate (36.36% vs 41.33% , P> 0.05) ,and and cumulative pregnancy rate(66.67% vs 53.70% , P> 0.05). Conclusion The qualified embryo rate and the cumulative pregnancy rate of CBAVD group were all decreased. No significant effect on the ICSI fertilization rate, cleavage rate, good quality embryo rate and cumulative pregnancy rate for patients with Varicocele and AZFc microdeletion.