Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Taiwan J Obstet Gynecol. 2013 Sep;52(3):329-34. doi: 10.1016/j.tjog.2012.08.003.
To evaluate the impact of the duration of cryopreservation of testicular sperm on clinical and neonatal outcomes after intracytoplasmic sperm injection (ICSI) for patients experiencing azoospermia.
This study included 132 azoospermic men who participated in 212 ICSI cycles. The participating men underwent testicular biopsy for the cryopreservation of tissue to be used for subsequent ICSI cycles. The duration of the storage of testicular sperm was determined by the time of oocyte retrieval. Fertilization, embryo development in vitro, pregnancy rates, and neonatal outcomes were assessed.
Although the mean percentage of viability decreased from 73.2% prior to freezing to 50.2% after thawing, viable spermatozoa were visualized subsequent to thawing of the tissue samples for all patients. The potential for fertilization and subsequent embryonic development was not influenced by the duration of sperm cryopreservation up to 2 years longer. The pregnancy outcomes also varied independently of the duration of sperm cryopreservation. The duration of storage did not appear to affect the neonatal outcomes adversely, including the Apgar score and intensive care unit admission rates, although neonatal outcomes were influenced by advanced maternal age. It also has no obvious impact on the major and minor congenital malformation rate of the newborns.
ICSI outcomes, pregnancy outcome, neonatal outcome, and congenital malformation rate appear not to be affected by the duration of the period of cryostorage. An earlier start of the ICSI cycle following the testicular sperm cryopreservation is preferable because longer preservation is associated with more advanced maternal age.
评估睾丸精子冷冻保存时间对无精子症患者行卵胞浆内单精子注射(ICSI)后临床和新生儿结局的影响。
本研究纳入了 132 名接受 212 个 ICSI 周期的无精子症男性。这些男性接受了睾丸活检,以便冷冻保存组织以备后续 ICSI 周期使用。睾丸精子的储存时间由卵母细胞采集时间决定。评估了受精、体外胚胎发育、妊娠率和新生儿结局。
尽管冷冻前精子的存活率从 73.2%降至冷冻后的 50.2%,但所有患者的组织样本解冻后均可见存活的精子。在冷冻保存时间长达 2 年的情况下,精子的受精能力和随后的胚胎发育能力不受影响。妊娠结局也与精子冷冻保存时间无关。储存时间似乎不会对新生儿结局产生不利影响,包括阿普加评分和入住重症监护病房的比率,尽管新生儿结局受产妇年龄的影响。它对新生儿的主要和次要畸形率也没有明显影响。
ICSI 结局、妊娠结局、新生儿结局和先天性畸形率似乎不受冷冻保存时间的影响。在进行睾丸精子冷冻保存后,更早开始 ICSI 周期更为理想,因为较长的保存时间与产妇年龄较大有关。