Chang H C, Hsieh J T, Liu S P, Law H S, Chen S Y, Yang Y S
Department of Urology, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 1999 Mar;98(3):171-4.
Both microsurgical epididymal sperm aspiration (MESA) and intracytoplasmic sperm injection (ICSI) are great advances in assisted reproductive techniques. By using the ICSI technique, frozen sperm from the epididymis can result in successful fertilization. The epididymal sperm retrieved via MESA can be cryopreserved for an in-vitro fertilization (IVF) procedure, thus, making repeat surgical retrieval of sperm unnecessary. We report a retrospective analysis of 24 ICSI cycles in 16 patients with obstructive or nonreconstructable azoospermia. Fresh epididymal sperm was used in 13 ICSI cycles and frozen-thawed epididymal sperm was used in the other 11. We compared the fertilization capability of ICSI using frozen-thawed epididymal sperm with fresh epididymal sperm. Eleven patients became pregnant and five of these pregnancies resulted from frozen epididymal sperm. The fertilization rate per oocyte was 58% with fresh sperm, and 66% with frozen-thawed sperm. The rate of clinical pregnancy for one embryo transfer was 46% with fresh sperm, and 45% with frozen-thawed sperm. There were no significant differences between fresh and frozen-thawed spermatozoa in the fertilization rate of oocytes or the clinical pregnancy rate. Our results suggest that we should cryopreserve supernumerary spermatozoa during a MESA/ICSI procedure in order to avoid repeated scrotal surgery.
显微外科附睾精子抽吸术（MESA）和卵胞浆内单精子注射术（ICSI）都是辅助生殖技术的重大进展。通过使用ICSI技术，来自附睾的冷冻精子能够实现成功受精。经MESA获取的附睾精子可被冷冻保存用于体外受精（IVF）程序，因此无需重复进行手术获取精子。我们报告了对16例梗阻性或不可重建性无精子症患者的24个ICSI周期的回顾性分析。13个ICSI周期使用新鲜附睾精子，另外11个使用冻融附睾精子。我们比较了使用冻融附睾精子与新鲜附睾精子进行ICSI的受精能力。11例患者怀孕，其中5例妊娠源于冷冻附睾精子。新鲜精子的每枚卵母细胞受精率为58%，冻融精子为66%。新鲜精子进行单胚胎移植的临床妊娠率为46%，冻融精子为45%。新鲜精子与冻融精子在卵母细胞受精率或临床妊娠率方面无显著差异。我们的结果表明，在MESA/ICSI程序中应冷冻保存多余的精子，以避免重复阴囊手术。
