Shibahara H, Hamada Y, Hasegawa A, Wakimoto E, Toji H, Shigeta M, Koyama K
Department of Obstetrics and Gynecology, Hyogo College of Medicine, Japan.
J Assist Reprod Genet. 1999 Nov;16(10):540-5. doi: 10.1023/a:1020501305235.
Intracytoplasmic sperm injection (ICSI) has been validated as a useful treatment in severe male-factor patients who could not achieve fertilization and live births by conventional in vitro fertilization treatment. To examine the impact of male factors on ICSI outcome, clinical laboratory data were retrospectively analyzed.
One hundred two cycles of ICSI treatment indicated by severe male-factor infertility were entered into this study. Sperm parameters including sperm motility, sperm concentration, and sperm motility index assessed by the Sperm Quality Analyzer were evaluated.
Five hundred seventy-six metaphase II oocytes retrieved were manipulated. The normal fertilization (2 PN) rate per oocyte was 64.9 +/- 26.0% (mean +/- SD). Of the 99 transfers, 31 clinical pregnancies were obtained, yielding an average pregnancy rate of 31.3% per transfer. The mean sperm motility, sperm concentration, and sperm motility index were 20.3 +/- 16.1% (range, 0 to 50%), 18.2 +/- 25.1 x 10(6)/ml (range, < 1 to 150 x 10(6)/ml), and 31.2 +/- 45.0 (range, 0 to 220), respectively. Sperm concentration did not have a significant impact on fertilization rate by ICSI. In four cases, ICSI was performed using totally immotile sperm and the fertilization rate was 43.5%, which was significantly lower than that of some of the other sperm motility groups, and no pregnancy could be achieved. In 14 cases in which the sperm motility index assessed by the Sperm Quality Analyzer was 0, the fertilization rate (50.0%) was significantly lower than in most of the other sperm motility index groups.
These findings suggest that in severe male-factor cases with totally immotile sperm or a sperm motility index of 0, the selection of good-quality sperm should be verified before injection.
卵胞浆内单精子注射（ICSI）已被证实是一种有效的治疗方法，适用于那些无法通过传统体外受精治疗实现受精和活产的严重男性因素患者。为了研究男性因素对ICSI结局的影响，我们对临床实验室数据进行了回顾性分析。
本研究纳入了102个由严重男性因素不育指征的ICSI治疗周期。通过精子质量分析仪评估精子参数，包括精子活力、精子浓度和精子活力指数。
共对576个回收的MII期卵母细胞进行了操作。每个卵母细胞的正常受精（2PN）率为64.9±26.0%（平均值±标准差）。在99次移植中，获得了31例临床妊娠，每次移植的平均妊娠率为31.3%。精子活力、精子浓度和精子活力指数的平均值分别为20.3±16.1%（范围，0至50%）、18.2±25.1×10⁶/ml（范围，<1至150×10⁶/ml）和31.2±45.0（范围，0至220）。精子浓度对ICSI受精率没有显著影响。在4例使用完全不动精子进行ICSI的病例中，受精率为43.5%，显著低于其他一些精子活力组，且未实现妊娠。在14例精子质量分析仪评估的精子活力指数为0的病例中，受精率（50.0%）显著低于大多数其他精子活力指数组。
这些发现表明，在严重男性因素病例中，若精子完全不动或精子活力指数为0，注射前应验证优质精子的选择。
