Cayan S, Lee D, Conaghan J, Givens C A, Ryan I P, Schriock E D, Turek P J
Department of Urology, University of California San Francisco School of Medicine, San Francisco, CA 94115-1695, USA.
Hum Reprod. 2001 Mar;16(3):495-9. doi: 10.1093/humrep/16.3.495.
The published experience with frozen-thawed epididymal spermatozoa and intracytoplasmic sperm injection (ICSI) suggests that fertilization and pregnancy success rates are comparable to those achieved with freshly retrieved spermatozoa. However, no study has exactly compared clinical outcomes between the two IVF/ICSI cycles in the same couples. To formally address this issue, we assessed ICSI outcomes in couples each of whom had had two IVF/ICSI cycles: one using fresh and the second using frozen-thawed epididymal spermatozoa obtained from a single aspiration procedure. From a pool of 101 consecutive patients undergoing IVF/ICSI with epididymal spermatozoa, 19 couples initially used fresh epididymal spermatozoa and subsequently underwent a second IVF/ICSI procedure with frozen-thawed spermatozoa from the same aspiration. Normal (2PN) oocyte fertilization rates, embryo quality and pregnancy rates were compared between the two IVF/ICSI cycles for each couple. In the fresh epididymal sperm group, 58.4% of the injected oocytes fertilized normally compared with 62.0% of the injected oocytes in the frozen-thawed epididymal sperm group, revealing no statistically significant difference. Graded embryo quality also did not differ significantly between the paired IVF/ICSI cycles. The clinical pregnancy rates were 31.6% (6/19) and 36.8% (7/19) in the first and second cycles respectively. All but one pregnancy were singletons. In summary, this study provides strong evidence to support the notion that motile, cryopreserved and thawed epididymal spermatozoa are equal to freshly retrieved spermatozoa for ICSI in couples with obstructive azoospermia.
已发表的关于冻融附睾精子和卵胞浆内单精子注射（ICSI）的经验表明，受精率和妊娠成功率与新鲜获取的精子相当。然而，尚无研究对同一对夫妇的两个体外受精/ICSI周期的临床结果进行确切比较。为了正式解决这个问题，我们评估了每对夫妇进行的两个体外受精/ICSI周期的ICSI结果：一个周期使用新鲜精子，另一个周期使用从单次抽吸程序中获得的冻融附睾精子。在101例连续接受附睾精子体外受精/ICSI的患者中，19对夫妇最初使用新鲜附睾精子，随后使用来自同一抽吸的冻融精子进行第二次体外受精/ICSI程序。比较每对夫妇两个体外受精/ICSI周期的正常（2PN）卵母细胞受精率、胚胎质量和妊娠率。新鲜附睾精子组中，58.4%的注射卵母细胞正常受精，而冻融附睾精子组中这一比例为62.0%，差异无统计学意义。配对的体外受精/ICSI周期之间分级胚胎质量也无显著差异。第一周期和第二周期的临床妊娠率分别为31.6%（6/19）和36.8%（7/19）。除一例妊娠外，其余均为单胎妊娠。总之，本研究提供了有力证据支持以下观点：对于梗阻性无精子症夫妇，活动的、冷冻保存和解冻的附睾精子在ICSI中与新鲜获取的精子效果相同。
