Moghadam Kenneth K, Nett Reed, Robins Jared C, Thomas Michael A, Awadalla Sherif G, Scheiber Michael D, Williams Daniel B
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Cincinnati College of Medicine, Cincinnati, OH 45040, USA.
J Androl. 2005 Sep-Oct;26(5):619-23. doi: 10.2164/jandrol.05018.
Our objective was to determine whether the presence of motility in surgically obtained sperm samples improves fertilization and pregnancy rates for patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). This was a retrospective study in a hospital-based infertility center. Sixty-seven couples with a diagnosis of azoospermia or severe oligozoospermia who had undergone a sperm retrieval procedure in conjunction with 100 IVF/ICSI cycles from 1995 to 2004 were evaluated. The impact of sperm motility on fertilization and clinical pregnancy rates was determined. The motile and nonmotile sperm groups differed in the number of mature oocytes retrieved (10.7 +/- 5.8 vs 13.4 +/- 6.0), but fertilization (56.7% vs 59.1%) and embryo cryopreservation rates (35.9% vs 39.3%) were statistically similar. Clinical pregnancy rates did not differ between the motile (38.5%) and nonmotile (31.2%) groups, nor did they differ between obstructive and nonobstructive patients (35.3% vs 26.7%). There was also no statistical difference in pregnancy rates between testicular and epididymal aspiration (35.3% vs 26.7%), although epididymal sperm were significantly more likely to be motile than testicular sperm (100% vs 39.3%, P < .0001). Epididymal aspiration is more likely to produce motile sperm than testicular sperm retrieval. The use of motile sperm from epididymal or testicular samples, however, does not appear to enhance fertilization or clinical pregnancy rates.
我们的目的是确定手术获取的精子样本中存在活力是否能提高接受体外受精/卵胞浆内单精子注射（IVF/ICSI）患者的受精率和妊娠率。这是一项在一家医院不孕症中心进行的回顾性研究。对1995年至2004年期间67对诊断为无精子症或严重少精子症且接受了精子提取程序并进行了100个IVF/ICSI周期的夫妇进行了评估。确定了精子活力对受精率和临床妊娠率的影响。有活力和无活力精子组在回收的成熟卵母细胞数量上有所不同（10.7±5.8对13.4±6.0），但受精率（56.7%对59.1%）和胚胎冷冻保存率（35.9%对39.3%）在统计学上相似。有活力组（38.5%）和无活力组（31.2%）的临床妊娠率没有差异，梗阻性和非梗阻性患者之间也没有差异（35.3%对26.7%）。睾丸抽吸和附睾抽吸的妊娠率也没有统计学差异（35.3%对26.7%），尽管附睾精子比睾丸精子更有可能具有活力（100%对39.3%，P<.0001）。附睾抽吸比睾丸精子提取更有可能产生有活力的精子。然而，使用来自附睾或睾丸样本的有活力精子似乎并不能提高受精率或临床妊娠率。
