Landes-Frauen-und Kinderklinik Linz, Kinderwunsch Zentrum, Linz, Austria.
Fertil Steril. 2011 Dec;96(6):1331-6. doi: 10.1016/j.fertnstert.2011.08.041. Epub 2011 Sep 29.
To evaluate whether the use of theophylline improves sperm motility and treatment outcome in frozen-thawed testicular sperm extraction (TESE).
Artificial sperm activation was offered to azoospermic patients between January and October 2010 in two different centers (identical lab conditions).
IVF units of public hospitals.
PATIENT(S): Sixty-five patients participated and gave informed consent.
INTERVENTION(S): Sibling oocytes were split into a study (intracytoplasmic sperm injection [ICSI] with thawed testicular sperm treated with theophylline) and a control group (ICSI with thawed untreated sperm).
MAIN OUTCOME MEASURE(S): Sperm motility, time for sperm selection, rates of fertilization, implantation, clinical pregnancy, and live birth.
RESULT(S): All patients but one (98.5%) showed a significant improvement in testicular sperm motility when theophylline was used. In addition, sperm selection took significantly less time in the study as compared with in the untreated control group. Corresponding rates of fertilization (79.9% vs. 63.3%) and blastulation (63.9% vs. 46.8%) were significantly increased. Significantly more patients achieved clinical pregnancy if embryos/blastocysts derived from oocytes that had been injected with pharmacologically stimulated testicular spermatozoa were transferred (53.9% vs. 23.8%). This also holds true for the implantation rate.
CONCLUSION(S): Theophylline turned out to be a reliable tool in stimulating testicular spermatozoa after thawing. Its immediate effect allows for faster and more accurate selection of viable sperm, which in turn improved fertilization and pregnancy outcome in this prospective study.
评估茶碱是否能改善冻融睾丸精子提取（TESE）中精子的活力和治疗效果。
2010 年 1 月至 10 月，在两个不同的中心（相同的实验室条件）向无精子症患者提供人工精子激活。
公立医院的体外受精单位。
65 名患者参与并同意。
将同胞卵母细胞分为研究组（用冻融睾丸精子进行胞浆内精子注射[ICSI]，并用茶碱处理）和对照组（用未处理的冻融精子进行 ICSI）。
精子活力、精子选择时间、受精率、着床率、临床妊娠率和活产率。
除 1 例患者外（98.5%），使用茶碱后睾丸精子活力均有显著改善。此外，与未处理的对照组相比，研究组的精子选择时间显著缩短。相应的受精率（79.9%对 63.3%）和囊胚形成率（63.9%对 46.8%）也显著增加。如果将来源于用药物刺激的睾丸精子进行注射的卵母细胞获得的胚胎/囊胚进行移植，那么实现临床妊娠的患者明显更多（53.9%对 23.8%）。这也适用于着床率。
茶碱在冻融后刺激睾丸精子是一种可靠的工具。它的即时效应使可行精子的选择更快、更准确，这反过来又提高了受精率和妊娠结局。
