Nghiên cứu hiệu quả phương pháp tiêm tinh trùng vào bào tương noãn bằng tinh trùng lấy từ mào tinh trong điều trị vô sinh

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 !"#$%&'()*+,-./0
0123.44561&17)/8
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;<'6 =#
$%$%4%22% "6> ;?145;1
23.445#@/8445+.41A+
,-6BC;?*,6D4E6FC
+961,.G%4."#$1+
1,+H4()I'J6)*;
+.4<J676(=6 )1,3K
A.4B?;<!=#
$*LME*0HNC*
A?*LME*0H.490:
4+,/8+.4O4K45P.*
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:?+W24FV4+HX IQ/<=#
@/8Y.1,1A2Z[;+S
24,+/AX3.4
&+S+B8.,#
R'\48/6*;+1
,;]+XE*F*H>.A0H#
U0H*1,Y/2B^4
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d,eB5Y.*LMf4K2
LM4,B^T
"T3/C0*;+.4
#geAB8^0^BY.1
,+Z[+Z[[h0H
*;1,#
$^*4,B^TBi
,2C/X4T45&*B**
33.#d10^*2C/,;
1,4S+H1^*-
FC,BijhX43.+.0*
2M.3A2C/,e_dg_#
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>04,B^TBi,2C/X4
O9463]2BK6&29-6B.145
>>[.**3
O*/&3Y.^*/#
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4]+7(4*&/B
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1,+Z[<J'=#
Hình 1.1. Cấu tạo tinh hoàn và mào tinh [32]
d*/WY.;+SB.4h6/026
/:*/:#@4WY.*//2
B*+H2S,A:+H#
 Sinh l qu trnh sinh tinh [33, 34].
Qu trình sinh tinh diễn ra liên tục t lúc bắt đầu dậy thì cho đn
tận cuối đời..B&.:p/B6B6
P,#
  
d*B4K4+W&[B**
/B6/B8.*8A\.0&
2#q5&/BB*B_#$/B
.24J2:+e.A4Y.8Bp
!
!
•:aS44p !"p/Ba2
NB4K4i4&61\*8;
F/A:..Bp45B1\*8A24
+eN:6B92:[B*/
B2:a:4#
•:a:4 ""p.2K8.6
/BBWB*/B2:}#
•:} #$"p2:/*8A\&2

B#$/B/B*B_1B5D4ZA
2…B5 †7!#
  #
‡.:/6B_482K': 
B__64fB__1B5D4ZA^B5† J#d*D4Z
A-‚ˆO82/.B#$B__X.
.[482K ./AP0,"#
qfP4.B5D4ZA^B5#‰482K';+D
. 7/61482K ]F/.
;6+M/Z.-?4C/B__#
 %
$P./0,..481B5D4
ZA^B5† J#d1.2:Pp2:4.D4ZA‚
2:4.D4ZAˆ#$P8.43.3*?
B*A,63*?/4B&-
23.NBt?*Y.P#
Q
Q
Hình 1.2. Qu trình hình thành tinh trùng [32]
& '()* }5‰2Bt:.heK6*:
2/%FCNhY.B5‰2#d*h/
45h+/Ci4*eY.8#
&+()pY..:/286+€.6he
K542C/P.eY.8:.n4OeKo#
&,#  "p;NBtY..AA84K
F.+/A0 eY.8&2Me1heK#
/0 12pB^2.+K0 .,6A2:
4524„F3.heK68:t,#R&
B^^?26j2njB^o#



$P,."9+-
.4*.29&#d*K
K[BH2:B„3*?B**Bg%2
eB#bCAMB,.2
9jB^9B*43.t,#
Hình 1.3. Cc giai đoạn bit ho t tinh tử thành tinh trùng [32].
3 14 5
$;.AC45{:,!7ŠQ
/#$,.1\eW#b16
,2C/.X&KKY.41
\+5AeWT#
$,[+/A4
/"#$/M/6e/]04?*#UA1AW
eT6,9W
04>\#d*BB.4e0
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2w6*O/A*#R+/A;+WN6
>\Y.,[:*#$W&46
:1./F/.,4;C/
M2*B„„^1>.N/&>:
1.,#
Rjh./4A2C/,$‹ga6~‹ga6
q‹gaŒ"6;.C/i,2C/WV4A
WBi^*4,B^T
<J(=61.?u2/.O.^,X4
<J!6JQ=#$u2W.4B^TBi,
2C/X4OK^^,2C/X4S4S
FC<J=#@N;,X4W

TBi^*W&4;?\W
OCV4#U8/2^Y.^*4,B
^T*;jh,X4#
Hình 1.4. Tinh trùng trưng thành [39]
 Điều hoà nội tiết nam giới
Vùng dư"i đồi bài tit hormon GnRH theo dạng xung có tc dụng
kích thích tuyn yên tổng hợp và bài tit ra hormon FSH và LH. Cũng
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giống như ,+6//B.4/++:
F#$:•glZ*WAB04Bg%26
--FC,6.Bg%291*WA
M%%6•gl%%0K3*?
,[40]#
d*B•%/+1* +WtB.4
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.2B46]145K„%%%+:e+41:-
j#l4•lY.,+--*B•%/+t
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<7'=#$%>Y.aB./'cc("61J(6 ).4
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177)+HBC;<7J=69%~:4@
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 81

3 6.#5-1789
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3H 6.-I9-J
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B45*-F*#$u2Tk4:XO./
t{%14t6m I!tu2/26Qc)‘QI't2
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Tk4:X4 )14.4B?
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Y.$t>ˆ$‰c#J7.461 (6!).4FV
4+HBC;1BHTk4:X<(!=#
dC:SY.k4:X1A2/8
8/.Tk4:X6e]Y..k4:
8/.+94*k4:2:8/.\*2eukO2
/8Y/8/Tk4:X#dE*Tk
4:XY/+e.*4284

OPIR0284"]1A*Bi84
+2%\4*4284;Tk4:X<(Q=#
‰Tk4:X523.O
1]H0H<(=#
OIp13.*1A;C/Bhk4:TB
8244*.2.2.#
OIp1A?C/BhT;C/Bhk4:T4
K244*.2.2.#
OIp?C/Bhk4:T45*+D+6Bhk4:
T#
04Bj?*B8Tk4:XBA
4C2*B&6,+X*.
:*A*.6&4„29&5.
<(c=#@>Y.|lvC/*B8Tk4:X
15%%%C^;B?;6+M/[
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3*?4BA+H24
4M5,64u2,+5Ou2,
B?;<(!=#@.;.OC/*B8BHTk
4:X?\B*4Y.,4G.Y.T
OV4^*,B?;<!=#
d^BY.Tk4:X8/.BC;
+Hi\5:B?2/&-8/.#
3F ST 
‚Z1A2444C>\
FC,6+S4&2,1,
FZ.B#RBHFZ?K24Z>
4*03.k4:.12Z>4*+…
3.;54:632BA4BH4*6:P#

}8BA.0,61A\6F
/6+2%1AC/BA4+94*#‚Z
1A45.B45&;FZ45
B.1.*A*,8/B
8#
3H U12 
dC^;m„6//\1
M45&/8…m4m.6C^Y.
*M5#g.C1ABH,0BHW4*6?„B.
Z1C.;
,0./W4*024\*2e6+S244
+94*+…64*+S24t^
BA4#dC^O24C^
48/>&+S6241,#
g.C24,Fh&4D
+HY.^A68/.*A*,#
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3V W<9 /-
R&B•%/+C4O40
/8Y.///15.+%B?;\
5%%#}8BA4,6^.h
+\/A*%%%%.+2#U0H1ABi*
ZB„2&2-?]KZB„&?
O1AW>\,#
 !"
3 &<-XY
•+S1;-J446i4X#
dE*%&+SBi\4*4284#R ()B
8%&+S45B')B8%&+S.B

1Ž4%%45BM<!'=#$%&+S;Ž4%%
h#d*B8%&+SBE4.B;BA
4A-+H642x%O5l
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3 &T<-X
$Z&+S2^*kD6 I!)
.4Z&+S1/j&2:&+S<! =#U0
H1ABi*&2:&+SO1A*+W^
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3 &T<Z
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1,<!J=69%’%3%?u2/]2 )*B
8Z[;+S<!7=#$Z&11AZ:
F.ZB5&1#UA4*B81
,+Z&12A-+H-6FV4+H
1A21,,-65x%
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33 SU1D-[
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;A4FC24+H1.
4/B3.#$284B8S14*
FCA-+H-6FV4+H4M5-
1,#@2C/4SAFV4[?4C/
,#‚C+91A2B5+HFC
B3.S1452
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C&*&2:FC646J )*;
+.4<!(=#

3F \<12-12
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^+^2+^M1\^>+/?^
>A:?+W<!!=#$u2.4BH&2:^+^
W5X5t6()BH&2:^+^
14.47t\2 (ŠJ)14!(t
14Q(t?u2/2()#@/8&2:^+^
1A2eA842w#
3H /K;,U
•f*tC2;2f:t.BC{H-B;
+6XKM&Y.+^M#$u2'r (mm
.#R2f*tC,FC84:
1A+S+M/2f*i4K&+^M?
/^.#~SM:?*;/1
A0H61A*+W^*B^4,
BP#
d*/8+.4?B/1A
BA./t*]&FV4+H*4>5
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*.444M5,6,BC;
1,+H#$:4Y.>/
h].0H*;1,+Z
[#
 #$%&'!()
33 &T] 
$Z[4'()*;61A
2+/8BE4./^2+4D4C
^6+/84D4C^?;Ž4
%Z[4;+S<!Q=#

33 &T] 
$Z[44.&*;XJ!Q)*
;1,15•gl:B?;
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+S.B6B2wD4,tF.4T-5
>ˆ"O1ABHZ&4:F.<Q'=#$Z[
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4D4;+W?42H-./BHt
^C6.124/0264h4:
C<Q 6QJ=#@.*C^C4T-O1A24
Z&+S<Q7=#
33 &T1G-X
$Z&+S6&16B2wBE41&
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#$&*B8Z&+S?1(I')B
8BHZ4Ž4%#
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333 &T<Z
$Z&14'IJ)*;1
,<!Q=#@/81A+BE4+1%&
1+4D4:02/<QJ=#
* #$%&'+$!()
R1,+Z[+/8BC;
,+//#d*B8/;1BA5
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3F @INW
U4K\4'c776u2'r'#mm.#
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B*4+W#}BAA\+W1

Ž4%&2:>*#U0H*;/1A+,&
‰•l%+:F./+,*4•gl•l#
$•gl^KpB8S1*-+WW6-
B?;65•l6%%B?;#b
•gl1C-,+H#U0H
*;/K+,•gl./#
3F @IN^-_
}8BV?64^2e^6KM4:68
?„6/+W#}1-C.?+W‰•l+S
W•gl•l#
3F @IN/`a-a-
g/+W+A\4+W64s4:
Z&6+HMB./6B86M4*AK-#
3F3 b:;
~2.\3*?#@/8\
2.4*1AB2w&Y.//6+45&
&1A8/\2.+.C842w#
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3FF WcZ Y
R1.Bu26()"45Bu
26 )"#@1.BBAB&
;BH61*-+WW21
*A6j1&N6B5M+W*
A#@2:145B?B.[*
AB,X+M/*-+WWS*AB?;
BH#$C*;1
K\4+9F%412:f./#
3FH & K
}?;B.*&[+/AXtBW

F&B?62:f2i4tBW6&B€
B?#U0H*;/BiSM
2:fŽ4%*HB?6*H,6.1A0HBi5
d‰N\4K6..t4.F&?
SM?A281A8/#
3FV b# 
•.BHB>1A8/4%.B6B2
4ZB5t+M/?632BH1,#
$%>Y.•$Hl^• "?3.BH.t+M/?
1A8/%.BJ)*;<(=#‰.4.6
2M0HhO1A8/468/
1,+H#
3Fd OPQ
•eTFZBC;Y.k4::X
#}4'()3KA.4B?;6J();
.4/*Q(I');.4>*#
}8‰$q$$61A45&BC;Ž4%p-
„6&2:+e./t4jY.
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8/t^B8‰$q$$1A+\5B?
245\26!I6
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d"#@.91A+
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>j4*k4:6\.2.+%.%2.4%k
4:#
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- R1,+Z[j#?"
H WkE
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- b,1*1„&H4#
- dj4146h4:6X.hX.h44.#
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H a9N
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7
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- R3.#—/^%#
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