Xie Duo, Qiu Zhuolin, Luo Chen, Chu Qingjun, Quan Song
Center of Reproductive Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2014 Jun;34(6):857-61.
To evaluate the impact of spermatozoa from different sources on normal fertilization of oocytes, embryo quality and embryo developmental potential in intracytoplasmic sperm injection (ICSI) cycles.
A retrospective analysis was conducted among 197 patients undergoing ICSI cycles in our center. The patients were classified into 3 groups according to the sources of semen, namely ejaculated spermatozoa group (n=102), percutaneous epididymal sperm aspiration (PESA) group (n=68), and testicular sperm aspiration (TESA) group (n=27). The ejaculated spermatozoa group was further classified into oligoasthenoteratozoospermia (n=67) and cryptozoospermia (n=35) subgroups. The normal fertilization, high-quality embryo, implantation and clinical pregnancy rates were compared among the groups; the rate of high-quality blastocyst formation in in-vitro culture of non-top quality embryos was also observed.
The patients with PESA showed significantly higher normal fertilization rate (75.6%) than those in oligoasthenoteratozoospermia (64.8%), cryptozoospermia (62.1%), and TESA (61.6%) groups (P<0.05). No significant differences were found in the high-quality embryo, implantation, and clinical pregnancy rates among the groups (P>0.05). The rate of high-quality blastocyst formation in the in-vitro culture of non-top quality embryos was also comparable among the groups (P>0.05).
Although spermatozoa obtained with by PESA is associated with a higher normal fertilization rate, the sources of spermatozoa do not significantly affect the embryonic quality and developmental potential in ICSI cycles.
评估不同来源的精子对卵胞浆内单精子注射(ICSI)周期中卵母细胞正常受精、胚胎质量及胚胎发育潜能的影响。
对在本中心接受ICSI周期治疗的197例患者进行回顾性分析。根据精液来源将患者分为3组,即射出精子组(n = 102)、经皮附睾精子抽吸术(PESA)组(n = 68)和睾丸精子抽吸术(TESA)组(n = 27)。射出精子组进一步分为少弱畸精子症(n = 67)和隐匿性精子症(n = 35)亚组。比较各组的正常受精率、优质胚胎率、着床率及临床妊娠率;同时观察非优质胚胎体外培养中优质囊胚形成率。
PESA组患者的正常受精率(75.6%)显著高于少弱畸精子症组(64.8%)、隐匿性精子症组(62.1%)和TESA组(61.6%)(P < 0.05)。各组间优质胚胎率、着床率及临床妊娠率差异无统计学意义(P > 0.05)。各组非优质胚胎体外培养中优质囊胚形成率也相当(P > 0.05)。
尽管通过PESA获得的精子正常受精率较高,但在ICSI周期中精子来源对胚胎质量和发育潜能无显著影响。