Scott S G, Mortimer D, Taylor P J, Leader A, Pattinson H A
Department of Obstetrics and Gynaecology, University of Calgary Health Sciences Centre, Alta.
CMAJ. 1990 Aug 15;143(4):273-8.
Although it is now accepted that cryopreserved semen must, on ethical and medicolegal grounds, be used for donor insemination many clinicians still believe that it has an unacceptably reduced fecundability rate as compared with fresh semen. We studied the outcome of 81 recipients who started therapeutic donor insemination (TDI) treatment during 1986 in a program that used exclusively cryopreserved semen; 55 had never undergone TDI and were receiving the first series (six cycles), 6 were receiving the second series (also six cycles), and 20 had achieved pregnancy through TDI previously and were starting the treatment again. Insemination with semen stored in 0.5-ml French straws was performed daily during the periovulatory period while the modified Insler score was 10 or greater out of 15. A total of 42 (52%) of the recipients became pregnant within six TDI cycles; 4 (10%) had a spontaneous abortion. An average of 4.8 straws were used per cycle among those who became pregnant and 5.1 per cycle among those who did not. On average 2.6 cycles were required to achieve pregnancy. The overall fecundability rate was 14.6%. We conclude that a TDI program involving exclusively frozen semen can be operated with a success rate comparable to rates achieved with fresh semen if a simple, established cryopreservation method and an uncomplicated clinical management protocol are used.
尽管从伦理和法医学角度来看，冷冻精液现在已被认可用于供精人工授精，但许多临床医生仍然认为，与新鲜精液相比，其受孕率降低到了不可接受的程度。我们研究了1986年期间在一个专门使用冷冻精液的项目中开始接受治疗性供精人工授精（TDI）治疗的81名受者的治疗结果；55名受者从未接受过TDI治疗，正在接受第一轮治疗（六个周期），6名受者正在接受第二轮治疗（同样是六个周期），20名受者此前已通过TDI成功受孕，现在又开始接受治疗。在排卵期周围，当改良的Insler评分在15分中达到10分或更高时，每天使用0.5毫升法式细管中储存的精液进行授精。共有42名（52%）受者在六个TDI周期内成功受孕；4名（10%）发生了自然流产。成功受孕的受者平均每个周期使用4.8根细管，未成功受孕的受者平均每个周期使用5.1根细管。平均需要2.6个周期才能成功受孕。总体受孕率为14.6%。我们得出结论，如果采用简单、成熟的冷冻保存方法和不复杂的临床管理方案，一个完全使用冷冻精液的TDI项目可以取得与使用新鲜精液相当的成功率。
