509例自精保存者冷冻精液去向分析

Analysis the fate of frozen semen of 509 males with autologous sperm preservation

目的分析自精保存者首个保存周期后冷冻精液的去向,为提升冷冻精液的保存价值提供依据。方法回顾性分析浙江省人类精子库2007年1月至2021年12月509例自精保存者的基本资料、精液保存情况和冷冻精液的去向等信息。自精保存者按照精液保存原因分为四组:疾病治疗组、单纯生殖保险组、高危职业组、不育症组;冷冻精液的去向分为五种情况:续费保存、使用、销毁、失访、无效保存。结果509例自精保存者平均保存(10.7±6.6)份冷冻精液,冷冻精液去向分别为:失访占48.5%,续费保存占44.4%,精液已使用占4.7%,精液销毁占1.6%,无效保存占0.8%;四组自精保存者中,不育症组的冷冻精液使用率(15.4%)显著高于其他组(P<0.01);冷冻精液的续费保存率和销毁率各组之间的差异无统计学意义(P>0.05)。结论精液冷冻保存是一种保护男性生育力切实可行的方法,但冷冻精液使用率极低、失访率过高,因此人类精子库需要优化自精保存流程和方案,加强自精保存者的随访,提高自精保存者冷冻精液使用率、降低其失访率,以提升冷冻精液的保存价值。

Objective To analyze the fate of frozen semen since the first retention cycle of males with autologous sperm preservation(ASP),and provide a basis for improving the preservation value of frozen semen.Methods We retrospectively analyzed the basic data,semen preservation status and the fate of frozen semen of 509 males with autologous sperm preservation in the Zhejiang Human Sperm Bank from January 2007 to December 2021.The men applying for ASP were divided into four groups according to the cause of semen preservation:disease treatment group,reproductive insurance group,high-risk occupation group,and infertility group.The fate of frozen semen is classified into five situations:renewal preservation,use,destruction,loss to follow-up,invalid preservation.Results Among 509 males applying for ASP with an average preservation of 10.7±6.6 frozen semen samples per person,the following directions were applied to frozen semen:48.5%were lost to follow-up,44.4%were renewed fee preservation,4.7%had semen used,1.6%were semen destroyed,and 0.8%were invalid preservation.Among the four groups of the men applying for ASP,the infertility group had a significantly higher use of frozen semen(15.4%)than the other groups(P<0.01).There were no significant differences between the groups in the rate of renewal preservation and destruction of frozen semen(P>0.05).Conclusions Semen cryopreservation is a practical and feasible method to preserve male fertility.However,the use of frozen semen was extremely low,and the loss to follow-up rate was too high.The human sperm bank need to optimize ASP processes and protocols,enhance the follow-up of ASP,improve the semen use rate of frozen semen from ASP,and reduce its loss to follow-up rate,in order to enhance the preservation value of frozen semen.