Nicopoullos J D M, Gilling-Smith C, Almeida P A, Ramsay J W A
Assisted Conception Unit, Chelsea & Westminster Hospital, London SW10 9NH, UK.
Hum Reprod. 2004 Mar;19(3):579-85. doi: 10.1093/humrep/deh092. Epub 2004 Jan 29.
The effects of source of sperm, aetiology and sperm cryopreservation on ICSI cycles in azoospermic men were evaluated. The effect of aetiology of azoospermia on embryo development was also assessed.
This study was a retrospective analysis of 154 cycles (91 couples) using surgically retrieved sperm. Outcome measures were fertilization rate (FR), implantation rate (IR), and clinical pregnancy rate (CPR) and livebirth rate (LBR) per transfer.
Our data demonstrated similar outcome between the use of epididymal or testicular sperm in men with obstructive azoospermic (OA). FR and IR were significantly lower (P < 0.05) using sperm from men with non-obstructive azoospermic (NOA), but although pregnancy outcome appeared lower, this did not reach statistical significance (P = 0.08). Cryopreservation of epididiymal sperm did not alter outcome, but the use of frozen-thawed testicular sperm did demonstrate a lower FR, with no statistical difference in IR or pregnancy outcome. Embryos derived from NOA sperm had impaired development beyond day 2 post-oocyte retrieval (OA, 44% <5 cell; NOA, 71% <5 cell; P = 0.002).
The use of sperm from men with NOA significantly affects fertilization and implantation in ICSI cycles. The use of frozen-thawed testicular sperm affects fertilization rate without significantly altering pregnancy outcome. The use of such data on which to base clinical decisions needs to be supported by the meta-analyses of previous reports.
评估了精子来源、病因及精子冷冻保存对无精子症男性卵胞浆内单精子注射（ICSI）周期的影响。还评估了无精子症病因对胚胎发育的影响。
本研究是一项对154个使用手术获取精子的周期（91对夫妇）的回顾性分析。观察指标为每次移植的受精率（FR）、着床率（IR）、临床妊娠率（CPR）和活产率（LBR）。
我们的数据显示，梗阻性无精子症（OA）男性使用附睾或睾丸精子的结果相似。非梗阻性无精子症（NOA）男性的精子使用时，FR和IR显著较低（P<0.05），但尽管妊娠结局似乎较低，但未达到统计学显著性（P = 0.08）。附睾精子冷冻保存未改变结局，但使用冻融睾丸精子确实显示出较低的FR，IR或妊娠结局无统计学差异。卵母细胞取出后第2天之后，源自NOA精子的胚胎发育受损（OA，44%<5细胞；NOA，71%<5细胞；P = 0.002）。
NOA男性精子的使用显著影响ICSI周期中的受精和着床。冻融睾丸精子的使用影响受精率，而未显著改变妊娠结局。临床决策所依据的此类数据的使用需要先前报告的荟萃分析的支持。
