Abdelmassih Vicente, Balmaceda Jose P, Tesarik Jan, Abdelmassih Roger, Nagy Zsolt P
Clínica e Centro de Pesquisa em Reproduçião Humana Roger Abdelmassih, Rua Maestro Elias Lobo 805, Jardim Paulista, Cep: 01433-000, São Paulo SP, Brazil.
Hum Reprod. 2002 Mar;17(3):736-40. doi: 10.1093/humrep/17.3.736.
It is not well defined whether the elapsed time after vasectomy has any influence on the outcome of IVF-ICSI using epididymal sperm. We analysed retrospectively the results of 151 ICSI cycles in which sperm of vasectomized men were used at different time periods after vasectomy.
Oocytes were obtained after a desensitizing ovarian stimulation protocol using GnRH agonist in association with recombinant FSH and HCG. Sperm were retrieved by percutaneous epididymal sperm aspiration. The cycles were split into three groups: < or =10 years after vasectomy (group 1, n = 47), 11-19 years after vasectomy (group 2, n = 79), and > or =20 years after vasectomy (group 3, n = 25).
As might be expected, the mean age of men differed in the three groups (group 3 > group 2 > group 1), and the mean age of the women was also significantly higher in group 3 than in groups 1 and 2, although no differences were described between groups 2 and 3. All other laboratory and clinical parameters were similar in the three groups. Ongoing pregnancy and implantation rates (34, 25, 8% and 22, 15, 6% respectively) decreased significantly from group 1 to group 3.
Pregnancy and implantation rates after ICSI with sperm from vasectomized men are negatively correlated with the time interval from vasectomy, which cannot be explained purely by male or female ageing.
输精管结扎术后经过的时间是否会对使用附睾精子的体外受精-卵胞浆内单精子注射（IVF-ICSI）结局产生影响，目前尚无明确定论。我们回顾性分析了151个ICSI周期的结果，这些周期使用了输精管结扎术后不同时间段的男性精子。
采用促性腺激素释放激素（GnRH）激动剂联合重组促卵泡生成素（FSH）和人绒毛膜促性腺激素（HCG）进行卵巢脱敏刺激方案后获取卵母细胞。通过经皮附睾精子抽吸术获取精子。这些周期被分为三组：输精管结扎术后≤10年（第1组，n = 47），输精管结扎术后11 - 19年（第2组，n = 79），以及输精管结扎术后≥20年（第3组，n = 25）。
正如预期的那样，三组男性的平均年龄不同（第3组>第2组>第1组），并且第3组女性的平均年龄也显著高于第1组和第2组，尽管第2组和第3组之间未描述差异。三组的所有其他实验室和临床参数相似。从第1组到第3组，持续妊娠率和着床率（分别为34%、25%、8%和22%、15%、6%）显著下降。
输精管结扎男性精子ICSI后的妊娠率和着床率与输精管结扎后的时间间隔呈负相关，这不能单纯用男性或女性年龄增长来解释。
