Nuñez-Calonge R, Cortes S, Gago M, López P, Caballero-Peregrin P
Reproduction Unit, CLTNTCA Tambre, Calle Tambre no. 8, 28002 Madrid, Spain.
ISRN Urol. 2012;2012:108576. doi: 10.5402/2012/108576. Epub 2012 Mar 5.
Objective. To optimise the use of freeze/thaw testicular immotile spermatozoa from nonobstructive azoospermia patients and to analyse the outcome of intracytoplasmic sperm injection (ICSI) of such spermatozoa. Methods. Testicular specimens were retrieved and cryopreserved from forty patients with nonobstructive azoospermia and underwent one cycle with thawed spermatozoa (Group I) that led to pregnancy in sixteen cases. Twenty-four patients of group I underwent treatment with the same batch of thawed spermatozoa (Group II). For the first ICSI attempt, injection was performed when motile spermatozoa were found. In group II, injection was performed when maximum motility was reached. We compared mean of fertilization rate, embryo quality, clinical pregnancy rate and embryo implantation rate. Results. The mean percentage of motility was significantly higher in the group II than in the group I (18, 6 versus 8, 2). Group I showed a significant decrease in fertilization rates when compared with cryopreserved testicular spermatozoa in group II (54% versus 72%, P < 0.05). No difference was noted between the cleavage rate, embryo quality, clinical pregnancy rates and implantation rates among group II and I. Conclusion. Fecundation rate can be significantly improved after in-vitro culture and sperm selection of frozen-thawed immotile testicular spermatozoa in patients with nonobstructive azoospermia.
目的。优化非梗阻性无精子症患者冻融后睾丸不活动精子的使用，并分析此类精子卵胞浆内单精子注射（ICSI）的结果。方法。从40例非梗阻性无精子症患者中获取睾丸标本并进行冷冻保存，其中一组（I组）使用解冻后的精子进行了一个周期的治疗，16例成功妊娠。I组中的24例患者使用同一批解冻精子进行治疗（II组）。对于首次ICSI尝试，当发现活动精子时进行注射。在II组中，当达到最大活动率时进行注射。我们比较了受精率、胚胎质量、临床妊娠率和胚胎着床率的均值。结果。II组的平均活动率百分比显著高于I组（18.6%对8.2%）。与II组冷冻保存的睾丸精子相比，I组的受精率显著降低（54%对72%，P<0.05）。II组和I组之间的卵裂率、胚胎质量、临床妊娠率和着床率没有差异。结论。对于非梗阻性无精子症患者，冻融后的不活动睾丸精子经体外培养和精子选择后，受精率可显著提高。
