冷冻睾丸精子行卵胞浆内单精子注射临床结局探讨

Outcome of Intracytoplasmic Sperm Injection Cycles With frozen-thawed Testicular Spermatozoa

目的探讨冷冻睾丸精子行卵胞浆内单精子注射(ICSI)对无精子症患者临床结局的影响。方法回顾性分析2017年1月至2018年12月在我院生殖中心经皮睾丸穿刺取精(TESA)行ICSI助孕的213个授精周期的临床资料。按精子来源分为两组,TESA冻精组(观察组):采用TESA冷冻精子,共114个周期;TESA组(对照组):采用新鲜TESA精子,共99个周期。比较两组的胚胎发育情况和临床结局。结果TESA冻精组正常受精率(2PN率)显著低于TESA组,差异具有统计学意义(64.26%vs 73.89%,P<0.01)。两组的2PN卵裂率、可用胚胎率、优质胚胎率和囊胚形成率差别无显著性(P>0.05)。两组的临床妊娠率、胚胎种植率、多胎妊娠率、异位妊娠率、早期流产率和分娩率差异没有统计学意义(P>0.05)。结论冷冻睾丸精子行ICSI的临床结局与新鲜睾丸精子总体相似。但需要注意冷冻睾丸精子可能降低ICSI后正常受精率。

Objective:To investigate the effect of intracytoplasmic sperm injection(ICSI)with frozen-thawed testicular sperm on clinical outcomes of patients with azoospermia.Methods:A retrospective analysis was carried out on 213 ICSI cycles adopting testicular aspiration(TESA)sperm in our center from January 2017 to December 2018.Patients were divided into two groups according to the source of sperm:frozen-thawed TESA group(group F-TESA,114 cycles)and fresh TESA group(group TESA,Control group,99 cycles).The outcomes of embryonic development and pregnancy were comparatively analyzed between two groups.Resuts:The fertilization rate in group F-TESA was significantly lower than that in group TESA(64.26%vs 73.89%,P<0.01).There were no significant differences in the rate of cleavage,available embryo,good-quality embryo,blastocyst formation rate between the two groups(P>0.05).There were also no significant differences in the rate of in the clinical pregnancy,embryo implantation,multiple pregnancy rate,ectopic pregnancy rate,early miscarriage,delivery rate between the two groups(P>0.05).Conclusion:The clinical outcomes of ICSI with frozen-thawed low-quality testicular sperm were similar to those with fresh testicular sperm.However,it should be noted that frozen-thawed testicular sperm may reduce the fertilization rate after ICSI.