上海市人类精子库捐精现状及临床应用回顾性分析

Retrospective study of sperm donation and its clinical use of Shanghai Human Sperm Bank

目的探讨上海市人类精子库捐精现状与临床应用，为中国精子捐献制度的完善提供理论依据。方法对上海市人类精子库自2003年3月至2010年12月间所有初次捐精者与合格捐精者的信息回顾性分析，研究内容包括：（1）捐精者筛查不合格原因；（2）合格捐精者脱失率及原因；（3）捐精动机；（4）精液标本冷冻前后参数；（5）捐献者精子用于辅助生殖治疗的结果。结果1．研究期间，共有12858名志愿者接受捐精筛查，只有2083名（16．2％）入选。落选的主要原因为：（1）精液参数未达到标准；（2）性传播疾病检测阳性结果。另外，约4．9％的合格捐精者脱失，其主要原因为（1）捐精期间多次精液检测未达到标准，丧失信心；（2）因免费医学检查而加入：（3）迁居外地。2．我库共冻存精液31056份，冷冻前后平均密度为（98．7±25．3）X106和（57．2±26．5）×10^6，前向运动精子比率为（62．1±15．3）％和（42．6±13．5）％。3．对外供精14181份，其中AID周期数为7341，妊娠率为20．13％，新生儿出生数为723人；体外受精．胚胎移植（IVF-ET）周期数为1521，妊娠率为38．66％，新生儿出生数为410人，未出现同一供精者使5名以上妇女受孕的情况。结论我国精子库已进入成熟发展阶段，遵循国家政策法规的严格管理。目前存在的问题是供精严重不足，这有赖于政策进一步完善。

Objective Explore the current condition of sperm donation and outcome of its cinical use, so to provide suggestion for policy making. Methods The retrospective research was based on the data of donors from January 2003 to December 2010. The investigated items included： the intention about sperm donation; the factors of drop-out; the reasons of midway withdraw of qualified donors; parameters of cryostored samples pre- and post-frosing, assistant reproductive techniques（ART） cycle number, pregnant rate and birth rate. Results 12 858 sperm donors were screened and 2 083 donors （16.2%） were recruited. Main reasons of drop out were unqualified semen parameters and positive results in sexual transmitted disease tests. There were 6.9 % qualified donors breaking off the program because of frustration by unqualified semen parameters, intention of free medical examination or job transfer. There were 31 056 vials of donors＇ semen cryopreserved. In 7 341 AID cycles, the clinical pregnant rate was 20.13%, live-births 723. In 1 521 IVF cycles, clinical pregnant rate was 38.66%, live-births 410. Conclusion The human semen banking in the China had developed into a regulary stage after the implementation of ＇Rules and Guidelines＇. The quality of donor sperm cryopreserved had increased. All the measures play an important roles in the goal that everyone enjoies reproductive health for all of the people in our country.