Zhai Dan-mei, Li Mu-jun, Jiang Li, Qin Ai-ping, Li Liu-ming, Hang Fu
Research Center of Reproductive Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
Zhonghua Nan Ke Xue. 2011 May;17(5):418-21.
To evaluate the results of requesting a second consecutive sperm ejaculate in order to reduce ICSI cycles by PESA or TESE on the day of oocyte pick-up in assisted reproductive technology (ART).
We collected 68 semen samples as a second consecutive ejaculate from 34 men, compared the semen volume and sperm concentration, motility and total count between the first and the second ejaculation, and analyzed the laboratory results and clinical outcomes of fertilization with the mixed sperm.
The 34 males ejaculated twice within 4 hours by masturbation, with an interval of 26-183 (94.9 +/- 39.8) minutes between the first and second ejaculation. The volume of the first ejaculate was (2.0 +/- 1.4) ml, significantly higher than that of the second ([1.5 +/- 0.9] ml) (P = 0.007), although the numbers of motile sperm and grade a + b sperm of the first ([40.8 +/- 25.3]% and [30.9 +/- 22.4]%) were significantly lower than those of the second ([52.2 +/- 21.1]% and [39.9 +/- 17.5]%) (P < 0.05). There were no statistically significant differences in the sperm concentration or total sperm count between the two ejaculates (P > 0.05). The ICSI, IVF + ICSI, and IVF cycles were 3, 3 and 28 respectively among the 34 couples undergoing ART. The number of retrieved oocytes, normal fertilization rate, high quality embryo rate and frozen cycles/fresh transfer cycles ratio were 15.5 +/- 8.7, 57.0% (247/433), 58.7% (145/247) and 20/24 for the IVF cycle, 21.7 +/- 8.3, 61.5% (40/65), 67.5% (27/40) and 3/2 for the ICSI cycle, and 10.0 +/- 2.6, 72.4% (21/29), 66.7% (14/21) and 3/3 for the IVF + ICSI cycle. Fourteen live births were achieved out of the 18 pregnancies, including 6 healthy boys and 9 healthy girls.
A clinical pregnancy rate of >30% can be achieved by requesting a second consecutive sperm ejaculate on the day of oocyte pick-up in order to collect more sperm and/or increase the total number of motile sperm for ART. And this method can avoid other invasive sperm processing techniques and the need of unnecessary micromanipulative fertilization.
评估在辅助生殖技术（ART）中，为减少卵母细胞采集日通过经皮附睾精子抽吸术（PESA）或睾丸精子提取术（TESE）进行的卵胞浆内单精子注射（ICSI）周期数，而要求连续第二次采集精液的效果。
我们收集了34名男性连续第二次射精的68份精液样本，比较了第一次和第二次射精之间的精液量、精子浓度、活力和总数，并分析了混合精子受精的实验室结果和临床结局。
34名男性通过手淫在4小时内射精两次，第一次和第二次射精间隔为26 - 183（94.9±39.8）分钟。第一次射精量为（2.0±1.4）ml，显著高于第二次射精量（[1.5±0.9]ml）（P = 0.007），尽管第一次射精的活动精子数和a + b级精子比例（[40.8±25.3]%和[30.9±22.4]%）显著低于第二次射精（[52.2±21.1]%和[39.9±17.5]%）（P < 0.05）。两次射精之间的精子浓度或总精子数无统计学显著差异（P > 0.05）。在接受ART的34对夫妇中，ICSI、IVF + ICSI和IVF周期分别为3个、3个和28个。IVF周期的获卵数、正常受精率、优质胚胎率和冷冻周期/新鲜移植周期比分别为（15.5±8.7）个、57.0%（247/433）、58.7%（145/247）和20/24，ICSI周期分别为（21.7±8.3）个、61.5%（40/65）、67.5%（27/40）和3/2，IVF + ICSI周期分别为（10.0±2.6）个、72.4%（21/29）、66.7%（14/21）和3/3。18次妊娠中有14例活产，包括6名健康男婴和9名健康女婴。
在卵母细胞采集日要求连续第二次采集精液，以便为ART收集更多精子和/或增加活动精子总数，可实现>30%的临床妊娠率。而且这种方法可以避免其他侵入性精子处理技术以及不必要的显微操作受精。
