精子冷冻对卵胞质内单精子注射治疗结果的影响

The effect on intracytoplasmic sperm injection with fresh and cryopreserved sperm

目的了解冷冻保存对射出精子和经皮附睾、睾丸微穿刺抽吸精子进行卵胞质内单精子注射(ICSI)临床结果的影响。方法将射出精子152个治疗周期和经皮附睾、睾丸微穿刺抽吸精子55个周期分别分为新鲜组和冷冻组,对其ICSI后的结果进行对照。结果射出精子新鲜组和冷冻组受精率、卵裂率和临床妊娠率(分别为79.70%vs76.79%、97.08%vs98.35%、39.02%vs37.93%)与经皮附睾、睾丸微穿刺抽吸精子新鲜组和冷冻组受精率、卵裂率和临床妊娠率/穿刺周期(分别为77.07%vs74.54%、97.47%vs94.31%、35.00%vs37.14%)均无显著差异(P>0.05)。结论精子的冷冻保存对射出精子和经皮附睾、睾丸微穿刺抽吸精子进行ICSI的临床结果没有影响,我们认为对于经皮附睾、睾丸微穿刺抽吸精子应该进行冷冻保存,以减少对附睾、睾丸的穿刺次数。

Objective To observe the effects of cryopreservated sperm on intracytoplasmic sperm injection （ICSI）. Methods 152 cycles of ICSI with ejaculated sperm and 55 cycles of ICSI with epididymal or testicular sperm were grouped as fresh and cryopreseved group; the fertility, oocyte cleavage and pregnancy rate were compared. Results No difference was existed between fresh and cryopreservated groups in fertility, oocyte cleavage and clinical pregnancy rate with ejaculated sperm （79.90% vs 76.79%, 97.08% vs 98.35%, 39.02% vs 37.93%, respectively） and epididymal or testicular sperm （77.07% vs 74.54%, 97.47% vs 94.31%, 35.00% vs 37.14%, respectively） （P 〉 0.05）. Concluslon The fertilization, oocyte cleavage and pregnancy rates in ICSI with cryopreserved sperm are as good as those of fresh-sperm. Therefore, when motile sperm is found in the thawed samples, additional testicular or epididymis fine needle aspiration can be avoided.