Subak L L, Adamson G D, Boltz N L
Department of Gynecology and Obstetrics, Stanford University School of Medicine, CA.
Am J Obstet Gynecol. 1992 Jun;166(6 Pt 1):1597-604; discussion 1604-6. doi: 10.1016/0002-9378(92)91548-o.
We evaluated the efficacy of fresh versus frozen sperm in therapeutic donor insemination.
Fifty-seven women underwent 72 courses of treatment (a maximum of six therapeutic donor insemination cycles--three fresh and three frozen) totaling 198 cycles. Each woman served as her own control and was prospectively randomized to receive a single, timed insemination of either fresh or frozen sperm.
Fecundity was 20.6% for fresh sperm cycles and 9.4% for frozen (p less than 0.03, by chi 2 analysis). Fresh cervical cap insemination fecundity was 20.3%; frozen was 7.8% (p less than 0.03, by chi 2 analysis). Fresh intrauterine insemination fecundity was 21.2%; frozen was 15.8% (p = 0.63, by chi 2 analysis). Fresh 3-month life-table pregnancy rates were 48% +/- 10%; frozen rates were 22% +/- 8% (p = 0.05 by Breslow analysis). Survival analysis with fixed covariates showed a positive association with the use of fresh sperm (p = 0.04).
Cycle fecundity was significantly greater with fresh sperm in women undergoing cervical cap insemination or intrauterine insemination and in women undergoing only cervical cap insemination. These results have important implications for contemporary management of patients undergoing therapeutic donor insemination with frozen sperm.
我们评估了新鲜精子与冷冻精子在治疗性供精人工授精中的疗效。
57名女性接受了72个疗程的治疗（最多六个治疗性供精人工授精周期——三个新鲜精子周期和三个冷冻精子周期），共计198个周期。每位女性作为自身对照，前瞻性随机分组接受单次定时授精，授精精子为新鲜精子或冷冻精子。
新鲜精子周期的受孕率为20.6%，冷冻精子周期为9.4%（经卡方分析，p<0.03）。新鲜精子宫颈帽授精受孕率为20.3%；冷冻精子为7.8%（经卡方分析，p<0.03）。新鲜精子宫腔内授精受孕率为21.2%；冷冻精子为15.8%（经卡方分析，p = 0.63）。新鲜精子3个月生命表妊娠率为48%±10%；冷冻精子为22%±8%（经Breslow分析，p = 0.05）。固定协变量的生存分析显示使用新鲜精子有正相关关系（p = 0.04）。
对于接受宫颈帽授精或宫腔内授精的女性以及仅接受宫颈帽授精的女性，新鲜精子的周期受孕率显著更高。这些结果对当代接受冷冻精子治疗性供精人工授精患者的管理具有重要意义。
