无精子症男性通过手术获取精子产生的冷冻胚胎：它们在临床上可行吗？
Frozen embryos generated from surgically retrieved sperm from azoospermic men: are they clinically viable?
作者信息
Nicopoullos James D M, Ramsay Jonathan W A, Gilling-Smith Carole, Almeida Paula A
机构信息
Chelsea and Westminster Hospital, 369 Fulham Rd., London, SW10 9NH, UK.
出版信息
J Assist Reprod Genet. 2004 Nov;21(11):401-7. doi: 10.1007/s10815-004-7528-5.
PURPOSE
To assess the viability of frozen-thawed embryos derived from intracytoplasmic sperm injection (ICSI) in azoospermic men.
METHODS
Retrospective analysis of 154 consecutive ICSI cycles using surgically retrieved sperm from azoospermic men and case-control comparison of subsequent frozen transfer cycles with those using embryos generated from ejaculated sperm.
RESULTS
Patient and fresh cycle characteristics were similar in both groups. There were no differences between the two groups in the proportion of pronucleate (54% and 62%), and cleavage-stage embryos thawed (46% and 38%), post-thaw survival rates (retrievals: 69%; ejaculated: 73%) or quality of frozen embryos subsequently transferred. Implantation was significantly lower in frozen cycles where embryos were generated from surgically retrieved sperm (0% versus 11.5%; p = 0.03). Both clinical pregnancy rate (5% versus 21%) and live-birth rate (0% versus 21%) were lower in this group, but only the difference in LBR reached borderline statistical difference (p = 0.10).
CONCLUSION
This small series demonstrates a significant impairment in implantation in FET cycles using embryos generated from surgically retrieved sperm and a trend towards a poorer pregnancy outcome.
目的
评估无精子症男性经卵胞浆内单精子注射（ICSI）获得的冻融胚胎的活力。
方法
回顾性分析154例连续的ICSI周期，这些周期使用从无精子症男性手术获取的精子，并将随后的冷冻移植周期与使用射出精子产生的胚胎的周期进行病例对照比较。
结果
两组患者及新鲜周期特征相似。两组在原核期胚胎比例（54%和62%）、解冻的卵裂期胚胎比例（46%和38%）、解冻后存活率（手术获取：69%；射出：73%）或随后移植的冷冻胚胎质量方面均无差异。由手术获取精子产生胚胎的冷冻周期着床率显著较低（0%对11.5%；p = 0.03）。该组临床妊娠率（5%对21%）和活产率（0%对21%）均较低，但仅活产率的差异达到临界统计学差异（p = 0.10）。
结论
这个小样本系列表明，使用手术获取精子产生的胚胎进行冻融胚胎移植（FET）周期时着床显著受损，且妊娠结局有较差的趋势。
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