Morris David S, Dunn Rodney L, Schuster Timothy G, Ohl Dana A, Smith Gary D
Department of Urology, University of Michigan, Ann Arbor, Michigan 48109-0617, USA.
J Urol. 2007 Nov;178(5):2087-91; discussion 2091. doi: 10.1016/j.juro.2007.07.022. Epub 2007 Sep 17.
The motility of testicular derived spermatozoa reflects viability and predicts success during intracytoplasmic sperm injection. Although improvements in sperm motility are seen after incubation for extended periods, no guidelines suggest duration or media use for optimal improvement in motility.
Between July 1999 and February 2005 testicular aspirations were performed on 95 men with azoospermia, including 51 with obstructive azoospermia and 44 with nonobstructive azoospermia. Sperm motility was determined at initial collection and following incubation for 24 or 48 hours in processing media or Ham's F10 + protein. A mixed regression model controlling for testis side, media and baseline motility was created to analyze the change in motility between 24 and 48 hours.
Mean motility improved from 3% to 20% at 24 hours and 25% at 48 hours for OA cases and from 0% to 5% at 24 hours and 11% at 48 hours for nonobstructive azoospermia cases. The improvement in motility from 24 to 48 hours was significant for obstructive azoospermia cases (p = 0.001). While media was a nonsignificant factor in regression models, when patients were grouped into categories of motility change there was a significantly better response to F10 compared to processing media (p = 0.03).
Incubation in processing media or Ham's F10 + albumin media improves sperm motility with significant improvement noted between 24 and 48 hours for obstructive azoospermia cases. Ham's F10 + albumin media may provide extra benefit for cases of nonobstructive azoospermia or nerve injury. These results suggest the ideal timing of oocyte retrieval for intracytoplasmic sperm injection correlates with 48-hour sperm incubation for obstructive azoospermia cases, and 24 hours for nonobstructive azoospermia and nerve injury cases.
睾丸来源精子的活力反映了其生存能力，并可预测胞浆内单精子注射的成功率。尽管长时间孵育后精子活力有所改善，但尚无关于最佳改善活力的孵育时间或所用培养基的指导原则。
1999年7月至2005年2月，对95例无精子症男性进行了睾丸穿刺，其中51例为梗阻性无精子症，44例为非梗阻性无精子症。在最初采集时以及在处理培养基或哈姆F10 + 蛋白质中孵育24或48小时后测定精子活力。建立了一个控制睾丸侧别、培养基和基线活力的混合回归模型，以分析24小时和48小时之间活力的变化。
梗阻性无精子症病例在24小时时平均活力从3%提高到20%，48小时时提高到25%；非梗阻性无精子症病例在24小时时从0%提高到5%，48小时时提高到11%。梗阻性无精子症病例在24小时至48小时期间活力的改善具有显著性（p = 0.001）。虽然培养基在回归模型中不是一个显著因素，但当将患者按活力变化类别分组时，与处理培养基相比，对F10的反应明显更好（p = 0.03）。
在处理培养基或哈姆F10 + 白蛋白培养基中孵育可提高精子活力，梗阻性无精子症病例在24小时至48小时期间有显著改善。哈姆F10 + 白蛋白培养基可能对非梗阻性无精子症或神经损伤病例有额外益处。这些结果表明，对于梗阻性无精子症病例，胞浆内单精子注射取卵的理想时间与精子孵育48小时相关，对于非梗阻性无精子症和神经损伤病例则与24小时相关。
