Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Ramat Gan, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Assist Reprod Genet. 2018 Apr;35(4):645-648. doi: 10.1007/s10815-018-1115-7. Epub 2018 Jan 15.
Partial thawing of a vial of cryopreserved sperm (shaving) is sometimes applied as a measure to preserve sperm for further use, particularly in cases of very restricted sperm quantity. However, mechanical violence may disrupt the sperm-wall and lead to impaired in-vitro fertilization (IVF) outcomes.
In a retrospective case-control study at a tertiary, university-affiliated medical center, we compared the IVF/intracytoplasmic sperm injection (ICSI) outcomes of patients who used donor sperm following partial thawing (shaving) of the vial of cryopreserved sperm (n = 99) to a control group consisting of patients for whom the vial of sperm was completely thawed before use (n = 99).
While no differences were observed in the rates of oocyte fertilization, the mean number of top-quality embryos (TQE) was significantly lower in the shaving group than in the complete thawing group (1.33 ± 0.17 vs. 1.87 ± 0.17, p < 0.02). Experimental analysis of aliquots from the same donors revealed significantly reduced motility in sperm samples that were shaved vs. fully thawed (6.5 vs. 37.1%, p < 0.001).
In cases in which available cryopreserved sperm samples are limited, shaving of the vial without thawing can be used but with caution and only when absolutely necessary. Further, large prospective studies are needed to better clarify whether there is post-thawing sperm damage and to compare IVF outcomes after these two thawing methods.
有时会采用部分解冻冷冻精子管(削薄)的方法来保存精子以备进一步使用,尤其是在精子数量非常有限的情况下。然而,机械暴力可能会破坏精子壁,导致体外受精(IVF)结果受损。
在一家三级大学附属医院的回顾性病例对照研究中,我们比较了使用部分解冻(削薄)冷冻精子管中的供精者进行 IVF/胞浆内单精子注射(ICSI)的患者(n=99)与完全解冻后使用精子管的患者(n=99)的 IVF/ICSI 结局。
虽然卵母细胞受精率没有差异,但削薄组的优质胚胎(TQE)平均数量明显低于完全解冻组(1.33±0.17 对 1.87±0.17,p<0.02)。对同一供体的样本进行实验分析表明,削薄组的精子样本活力明显低于完全解冻组(6.5 对 37.1%,p<0.001)。
在可用的冷冻精子样本有限的情况下,可以使用不进行完全解冻的管削薄方法,但需谨慎且仅在绝对必要时使用。此外,还需要进行大型前瞻性研究,以更好地阐明是否存在解冻后精子损伤,并比较这两种解冻方法的 IVF 结局。