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使用患有恶性肿瘤男性的冷冻精子进行胞浆内单精子注射(ICSI)可获得较高的妊娠率。

Intracytoplasmic sperm injection (ICSI) using cryopreserved sperm from men with malignant neoplasm yields high pregnancy rates.

作者信息

Hourvitz Ariel, Goldschlag Dan E, Davis Owen K, Gosden Lucinda Veeck, Palermo Gianpiero D, Rosenwaks Zev

机构信息

IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Fertil Steril. 2008 Sep;90(3):557-63. doi: 10.1016/j.fertnstert.2007.03.002. Epub 2008 Aug 9.

Abstract

OBJECTIVE

To investigate the efficacy of IVF-intracytoplasmic sperm injection (ICSI) in patients who cryobanked semen before cancer treatment.

DESIGN

Retrospective consecutive study.

SETTING

University-based IVF unit.

PATIENT(S): One hundred eighteen couples undergoing IVF-ICSI using pretreatment frozen sperm.

INTERVENTION(S): Treatment follow-up.

MAIN OUTCOME MEASURE(S): Semen parameters and clinical pregnancy rates.

RESULT(S): One hundred eighteen couples underwent 169 IVF cycles using pretreatment cryopreserved sperm; the average sperm count was 66.5 x 10(6)/mL, and the average motility was 45.6%. Post-thaw sperm average density was 40.9 x 10(6)/mL with 14.2% motility. The clinical pregnancy rate was 56.8% per retrieval; 96 pregnancies were achieved, resulting in 126 children born and 11 spontaneous abortions. Patients with prostate cancer had the worst semen parameters before sperm banking and the lowest clinical pregnancy rates.

CONCLUSION(S): IVF-ICSI is the recommended treatment for most couples with cryopreserved sperm for male cancer. High pregnancy and delivery rates after IVF-ICSI using cryopreserved sperm from patients with cancer should encourage all reproductive-age males to cryobank semen immediately after diagnosis; physicians should discuss this and advise freezing multiple samples before treatment.

摘要

目的

探讨体外受精-卵胞浆内单精子注射(ICSI)对癌症治疗前冷冻精液患者的疗效。

设计

回顾性连续研究。

地点

大学附属体外受精中心。

患者

118对使用治疗前冷冻精子进行体外受精-ICSI的夫妇。

干预措施

治疗随访。

主要观察指标

精液参数和临床妊娠率。

结果

118对夫妇使用治疗前冷冻精子进行了169个体外受精周期;平均精子计数为66.5×10⁶/mL,平均活力为45.6%。解冻后精子平均密度为40.9×10⁶/mL,活力为14.2%。每次取卵的临床妊娠率为56.8%;共实现96次妊娠,产下126名婴儿,11例自然流产。前列腺癌患者在精子冷冻保存前精液参数最差,临床妊娠率最低。

结论

对于大多数有冷冻精子的男性癌症夫妇,体外受精-ICSI是推荐的治疗方法。使用癌症患者冷冻精子进行体外受精-ICSI后较高的妊娠和分娩率应促使所有育龄男性在确诊后立即冷冻精液;医生应讨论此事并建议在治疗前冷冻多个样本。

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