Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Taiwan J Obstet Gynecol. 2013 Sep;52(3):351-5. doi: 10.1016/j.tjog.2013.06.001.
To determine whether advanced male age influences the outcome of intracytoplasmic sperm injection (ICSI) following the cryopreservation of spermatozoa obtained through testicular sperm extraction (TESE).
Data were collected from infertile couples suffering from azoospermia who underwent TESE and ICSI from January 1998 to August 2010. There were 212 ICSI cycles using extracted testicular sperm after cryopreservation in this retrospective clinical analysis. The participating men all underwent testicular biopsy and subsequent tissue cryopreservation in a single academic tertiary care medical center. Those cryopreserved sperm were used during consecutive intracytoplasmic sperm injection treatment cycles. Female partners underwent individualized controlled ovarian hyperstimulation programs.
A total of 184 ICSI cycles were divided into the following two evaluation designs: (1) total cycles irrespective maternal age; (2) ICSI cycles with maternal age <34 years. Male partners were stratified into age categories at 5-year intervals (31-35 years, 36-40 years, and 41-51 years) in these two designs. In the first design, most outcomes of assisted reproductive techniques were similar during the three groups, but the maternal age is much lower in the first group, and the mean number of retried oocytes and estradiol level on the day of human chorionic gonadotropin injection was significantly higher in the first group. In the second design, the outcome of intracytoplasmic sperm injection and clinical factors including the estradiol level on the day of human chorionic gonadotropin injection, the number of retrieved oocytes, the rate of cleaved oocytes, the number of transferred embryos, the numbers of transferred good embryos, the clinical pregnancy rate per transfer cycle and the implantation rate were similar among the three groups of women aged <34 years after adjusting for female age.
There is insufficient evidence to demonstrate an unfavorable effect of advanced paternal age on the fertility outcome for TESE-ICSI. The thawed testicular spermatozoa from males aged ≤ 40 years did not have an adverse impact on ICSI outcomes.
确定男性年龄的增加是否会影响通过睾丸精子提取（TESE）冷冻保存的精子进行胞浆内单精子注射（ICSI）的结果。
本回顾性临床分析收集了 1998 年 1 月至 2010 年 8 月因无精子症而接受 TESE 和 ICSI 的不育夫妇的数据。在这项研究中，共有 212 个 ICSI 周期使用了冷冻保存的提取睾丸精子。所有参与研究的男性都在一家学术性三级医疗中心接受了睾丸活检和随后的组织冷冻保存。这些冷冻保存的精子在随后的胞浆内单精子注射治疗周期中使用。女性伴侣接受了个体化的控制性卵巢过度刺激方案。
总共 184 个 ICSI 周期分为以下两种评估设计：（1）不考虑母体年龄的总周期；（2）母体年龄<34 岁的 ICSI 周期。在这两种设计中，男性伴侣按 5 年间隔分为年龄组（31-35 岁、36-40 岁和 41-51 岁）。在第一种设计中，三组辅助生殖技术的大多数结果相似，但第一组的母体年龄较低，人绒毛膜促性腺激素注射日的平均重试卵数和雌二醇水平显著较高。在第二种设计中，在调整女性年龄后，三组年龄<34 岁的女性的 ICSI 结局和临床因素（包括人绒毛膜促性腺激素注射日的雌二醇水平、取回的卵数、分裂卵的比例、转移胚胎的数量、转移的优质胚胎的数量、每个转移周期的临床妊娠率和着床率）相似。
没有足够的证据表明父亲年龄的增加对 TESE-ICSI 的生育结果有不利影响。年龄≤40 岁的男性冷冻睾丸精子对 ICSI 结果没有不良影响。
