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注射的睾丸精子的状况/状态对睾丸切开取精术-卵胞浆内单精子注射-胚胎移植(TESE-ICSI-ET)周期结局的影响。

The effect of condition/state of testicular spermatozoa injected to the outcome of TESE-ICSI-ET cycles.

作者信息

Konc Janos, Kanyó Katalin, Cseh Sandor

机构信息

Infertility and IVF Center of Buda, Saint Janos Hospital, Budapest, Hungary.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2008 Nov;141(1):39-43. doi: 10.1016/j.ejogrb.2008.06.004. Epub 2008 Aug 8.

Abstract

OBJECTIVE

The effect of state/condition of spermatozoa (fresh/motile, fresh/immotile, frozen/motile and frozen/immotile) to fertilization, embryo formation/development, implantation and pregnancy/delivery and abortion rates were studied.

STUDY DESIGN

The data of a total of 167 TESE-ICSI-ET cycles with fresh and cryopreserved, motile and immotile testicular spermatozoa collected with testicular biopsy from patients suffering from non-obstructive azoospermia were analyzed retrospectively. Analysis of variance (ANOVA) was used to distinguish the group effects in fertilization, embryo formation, and implantation ratio. The group effect was evaluated by using non-parametric statistics and the independent grouping variable was also the "semen state/condition". "Semen state/condition" groups were created according to fresh or frozen, and motile or non-motile (immotile) characteristics. For comparing the four groups, Kruskal-Wallis ANOVA and Median-test was applied. The analysis was carried out using Statistica for Windows (StatSoft, Inc., Chicago, USA).

RESULTS

Independently of state/condition of testicular spermatozoa injected into oocytes, no differences were found in fertilization and implantation/pregnancy rates. No difference was obtained in embryo development of oocytes injected with fresh/immotile or frozen/motile spermatozoa. However, difference was found in embryo development of oocytes injected with fresh/motile or frozen/immotile testicular spermatozoa (87% vs. 73%; P<0.04). Comparing embryo development of oocytes injected with fresh vs. frozen spermatozoa difference was also found (83% vs. 74%; P<0.01). No difference was found in the abortion rates between the groups. Differences were observed in the implantation rates, however, these differences could not be verified statistically.

CONCLUSION

The presented data show that condition of injected testicular spermatozoa has influence to embryo development and even frozen/immotile testicular spermatozoa is able to induce/support fertilization and early embryo development.

摘要

目的

研究精子的状态/条件(新鲜/活动、新鲜/不活动、冷冻/活动和冷冻/不活动)对受精、胚胎形成/发育、着床以及妊娠/分娩和流产率的影响。

研究设计

回顾性分析了167例非梗阻性无精子症患者经睾丸活检收集的新鲜和冷冻、活动和不活动的睾丸精子进行睾丸精子提取-卵胞浆内单精子注射-胚胎移植(TESE-ICSI-ET)周期的数据。采用方差分析(ANOVA)来区分受精、胚胎形成和着床率方面的组间效应。使用非参数统计评估组间效应,独立分组变量也是“精液状态/条件”。根据新鲜或冷冻以及活动或不活动(不活动)特征创建“精液状态/条件”组。为比较这四组,应用了Kruskal-Wallis方差分析和中位数检验。使用适用于Windows的Statistica(StatSoft公司,美国芝加哥)进行分析。

结果

无论注入卵母细胞的睾丸精子状态/条件如何,受精率和着床/妊娠率均无差异。注入新鲜/不活动或冷冻/活动精子的卵母细胞在胚胎发育方面无差异。然而,注入新鲜/活动或冷冻/不活动睾丸精子的卵母细胞在胚胎发育方面存在差异(87%对73%;P<0.04)。比较注入新鲜与冷冻精子的卵母细胞的胚胎发育也发现存在差异(83%对74%;P<0.01)。各组间流产率无差异。着床率存在差异,然而,这些差异无法通过统计学验证。

结论

所呈现的数据表明,注入的睾丸精子条件对胚胎发育有影响,甚至冷冻/不活动的睾丸精子也能够诱导/支持受精和早期胚胎发育。

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