Service d'Histologie-Embryologie-Biologie de la Reproduction, Hôpital Cochin, Université Paris Descartes, Paris, France.
Fertil Steril. 2011 Dec;96(6):1315-9. doi: 10.1016/j.fertnstert.2011.09.035. Epub 2011 Nov 1.
To assess the effect of leukocytospermia on assisted reproductive technology outcomes.
Retrospective analysis.
University laboratory.
PATIENT(S): Couples attending the infertiliy clinic and involved in ART program for IVF or ICSI.
INTERVENTION(S): During a 7-year follow-up in an assisted reproductive technology program, leukocytospermia was routinely determined using the peroxidase technique. Donor sperm were excluded from the study.
MAIN OUTCOME MEASURE(S): Egg retrievals (N = 3,508) were distributed in 3 groups according to the leukocyte levels in semen from which fertilizing sperm were extracted: group 1, absence of leukocytes (n = 3,026); group 2, moderate leukocytospermia (<10(6)/mL) (n = 344); or group 3, high leukocytospermia (≥10(6)/mL) (n = 138). They resulted in 1,463 IVF and 2,045 intracytoplasmic sperm injection procedures that gave 802 clinical pregnancies.
RESULT(S): Surprisingly, the fertilization rate, cleavage rate, clinical pregnancy rate, gestational age, and mean infant weight were significantly improved when seminal leukocytes were present, regardless of the technique used. The only negative side effects associated with a high level of seminal leukocytes (group 3) were an elevated rate of early pregnancy loss (from 26.6% to 40.5%) and a 3-fold increase in the percentage of ectopic pregnancies.
CONCLUSION(S): At moderate levels (<10(6)/mL), leukocytospermia appears to be physiologic. It is associated with improved sperm fertilization ability and pregnancy outcome. At higher concentrations, leukocytospermia alters neither sperm fertilization ability nor the probability of clinical pregnancy when compared with nonleukocytic patients with infertility. However, the pregnancy outcome is reduced.
评估白细胞精液症对辅助生殖技术结局的影响。
回顾性分析。
大学实验室。
不孕不育门诊就诊并参与体外受精或卵胞浆内单精子注射（ICSI）ART 项目的夫妇。
在辅助生殖技术项目的 7 年随访期间，常规使用过氧化物酶技术确定白细胞精液症。排除供精者。
根据提取受精精子的精液中白细胞水平，将卵母细胞回收（N=3508）分为 3 组：组 1，无白细胞（n=3026）；组 2，中度白细胞精液症（<106/mL）（n=344）；或组 3，重度白细胞精液症（≥106/mL）（n=138）。这些患者共进行了 1463 次体外受精和 2045 次卵胞浆内单精子注射，获得 802 例临床妊娠。
令人惊讶的是，无论使用哪种技术，只要精液中存在白细胞，受精率、卵裂率、临床妊娠率、胎龄和平均婴儿体重均显著提高。与高浓度白细胞（组 3）相关的唯一负面影响是早期妊娠丢失率升高（从 26.6%升至 40.5%）和异位妊娠率增加 3 倍。
在中度水平（<106/mL）下，白细胞精液症似乎是生理性的。它与提高精子受精能力和妊娠结局相关。在较高浓度下，与白细胞非精液症不孕患者相比，白细胞精液症既不改变精子受精能力，也不改变临床妊娠的可能性。但是，妊娠结局降低。
