Esteves Sandro C, Schneider Danielle T, Verza Sidney
Androfert, Male Reproduction Reference Center, Av. Dr. Heitor Penteado 1464, Campinas, Sao Paulo, Brazil.
Int Braz J Urol. 2007 Nov-Dec;33(6):795-802. doi: 10.1590/s1677-55382007000600007.
The aim of this study was to analyze the influence of autoantibodies against spermatozoa present in the semen on the outcome of in vitro fertilization with intracytoplasmic sperm injection (ICSI).
We performed a retrospective analysis of clinical and laboratorial data from a six year-period ICSI cycles. Screening for the presence of ASA in the semen, by using the direct immunobeads test (IBT), was available for 351 cycles. According to the percentage of antibody-bound spermatozoa in the semen, we divided the cycles in four groups: I (n = 194): 0%-10% ASA; II (n = 107): 11%-20%; III (n = 33): 21%-50% and IV (n = 17): 51%-100% ASA. Additionally, a group of 349 ICSI cycles performed with ejaculated spermatozoa from oligo/asthenozoospermic men who had insufficient number of motile sperm available for ASA screening was included for comparison. ICSI outcomes were compared among groups and included fertilization rate (2 PN), cleavage rate, cleavage velocity, embryo quality, clinical pregnancy and miscarriage rates. Data were examined statistically, with an alpha level of 5% considered significant.
Fertilization, cleavage rate and velocity, percentage of good quality embryos, as well as clinical pregnancy and miscarriage rates did not differ among different ASA levels groups. ICSI outcomes in men exhibiting different levels of autoimmunity against spermatozoa did not differ from those with severely abnormal seminal parameters.
Our data indicate that intracytoplasmic sperm injection (ICSI) outcomes are not influenced by ASA levels on sperm.
本研究旨在分析精液中存在的抗精子自身抗体对卵胞浆内单精子注射(ICSI)体外受精结局的影响。
我们对6年期间ICSI周期的临床和实验室数据进行了回顾性分析。通过直接免疫珠试验(IBT)对351个周期的精液进行抗精子抗体(ASA)筛查。根据精液中抗体结合精子的百分比,我们将这些周期分为四组:I组(n = 194):ASA为0%-10%;II组(n = 107):11%-20%;III组(n = 33):21%-50%;IV组(n = 17):51%-100% ASA。此外,纳入一组349个ICSI周期作为对照,这些周期使用的是少弱精子症男性射出的精子,其活动精子数量不足以进行ASA筛查。比较各组间的ICSI结局,包括受精率(2PN)、卵裂率、卵裂速度、胚胎质量、临床妊娠率和流产率。对数据进行统计学检验,α水平为5%时认为差异有统计学意义。
不同ASA水平组之间的受精率、卵裂率和速度、优质胚胎百分比以及临床妊娠率和流产率均无差异。对精子表现出不同自身免疫水平男性的ICSI结局与精液参数严重异常男性的结局无差异。
我们的数据表明,卵胞浆内单精子注射(ICSI)结局不受精子上ASA水平的影响。