Department of Urology, Shanghai Human Sperm Bank, Shanghai Institute of Andrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China.
Asian J Androl. 2010 May;12(3):356-62. doi: 10.1038/aja.2010.12. Epub 2010 Mar 29.
Sperm banking can preserve male fertility effectively, but the current conditions of sperm cryopreservation in China have not been investigated. This retrospective investigation was based on data collected at multiple centres in China from January 2003 to December 2008. The collected data included urogenital history, indication for cryopreservation, semen parameters, use rate, type of assisted reproductive technique (ART) treatment and pregnancy outcome. The study population included 1 548 males who had banked their semen during the study period at one of the clinics indicated above. Approximately 1.9% (30/1 548) of the cryopreserved semen samples were collected from cancer patients; about 88.8% (1 374/1 548) of the patients had banked their semen for ART and 8.6% (134/1 548) had a male infertility disease (such as anejaculation, severe oligozoospermia and obstructive azoospermia). The total use rate of cryopreserved semen was 22.7% (352/1 548), with 119 live births. The cancer group use rate was 6.7% (2/30), with one live birth by intracytoplasmic single sperm injection (ICSI). The ART group use rate was 23.2% (319/1 374), with 106 live births. The reproductive disease group use rate was 23.1% (31/134), with 12 live births. The semen parameters in each category varied; the cancer patient and infertility disease groups had poor semen quality. In vitro fertilization (IVF) and ICSI were the most common ART treatments for cryopreserved sperm. Semen cryopreservation as a salvage method is effective, but in many conditions it is underutilized, especially in cancer patients. Lack of awareness, urgency of cancer treatment and financial constraints are the main causes of the low access rate. The concept of fertility preservation should be popularized to make better use of this medical service in China.
精子库可以有效地保存男性生育能力,但目前中国的精子冷冻保存情况尚未得到调查。本回顾性调查基于 2003 年 1 月至 2008 年 12 月期间在中国多个中心收集的数据。收集的数据包括泌尿生殖史、冷冻保存指征、精液参数、使用率、辅助生殖技术(ART)治疗类型和妊娠结局。研究人群包括在上述诊所之一在研究期间冷冻精液的 1548 名男性。约 1.9%(30/1548)的冷冻精液样本来自癌症患者;约 88.8%(1374/1548)的患者为 ART 而冷冻精液,8.6%(134/1548)患有男性不育症(如无精症、严重少精症和梗阻性无精症)。冷冻精液的总使用率为 22.7%(352/1548),有 119 例活产。癌症组使用率为 6.7%(2/30),1 例通过胞浆内单精子注射(ICSI)活产。ART 组使用率为 23.2%(319/1374),106 例活产。生殖疾病组使用率为 23.1%(31/134),12 例活产。每个类别的精液参数都有所不同;癌症患者和不育症患者的精液质量较差。体外受精(IVF)和 ICSI 是冷冻精液最常用的 ART 治疗方法。作为一种挽救方法,精子冷冻保存是有效的,但在许多情况下,它的利用率较低,尤其是在癌症患者中。意识不足、癌症治疗的紧迫性和经济限制是低利用率的主要原因。应该普及生育力保存的概念,以便在中国更好地利用这项医疗服务。