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父亲年龄增加和射精禁欲时间延长会对卵胞浆内单精子注射(ICSI)结果产生负面影响,这些结果来自于卵子共享捐赠周期。

Increasing paternal age and ejaculatory abstinence length negatively influence the intracytoplasmic sperm injection outcomes from egg-sharing donation cycles.

机构信息

Fertility Medical Group, São Paulo/SP, Brazil.

Sapientiae Institute, São Paulo/SP, Brazil.

出版信息

Andrology. 2020 May;8(3):594-601. doi: 10.1111/andr.12737. Epub 2019 Dec 13.

Abstract

BACKGROUND

The paternal role in embryogenesis is much more than providing a haploid genome. The spermatozoa have crucial roles related to embryogenesis' epigenetic regulation, fusion of gametes, and cleavage, which may influence intracytoplasmic sperm injection outcomes.

OBJECTIVES

To study whether paternal age, length of ejaculatory abstinence and semen parameters influence the outcomes of intracytoplasmic sperm injection in the oocyte recipients from egg-sharing donation cycles.

MATERIALS AND METHODS

This historical cohort study involved 427 oocyte recipient intracytoplasmic sperm injection cycles, from 321 patients undergoing egg-sharing donation cycles from January 2015 to May 2017, in a private in vitro fertilization center. Electronic medical records of donors and recipients intracytoplasmic sperm injection cycles were reviewed. The impact of male age, length of ejaculatory abstinence, and semen parameters on recipients' intracytoplasmic sperm injection outcomes were investigated using general mixed models. Implantation, pregnancy, and live birth rates were the primary outcome measures.

RESULTS

Paternal age negatively affected fertilization, day 3 top-quality embryos, day 3 normal embryo cleavage speed, blastocyst formation, high-quality blastocysts, and implantation, and was correlated with diminished pregnancy and live birth rates. Length of ejaculatory abstinence negatively influenced the rates of day 3 top-quality embryos, normal embryo development on day 3, blastocyst development, and implantation. Sperm count positively affected the rates of fertilization, blastocyst development, and implantation. The percentage of progressive sperm motility positively affected day 3 normal embryo development rate and implantation rate. Total motile sperm count positively affected blastocyst development rate and implantation rate.

DISCUSSION AND CONCLUSION

Additional tracking of the influence of male characteristics on intracytoplasmic sperm injection outcomes should be stimulated. Paternal age is not manageable, but reducing length of ejaculatory abstinence could be an alternative approach to improve the outcomes of intracytoplasmic sperm injection.

摘要

背景

父亲在胚胎发生中的作用不仅仅是提供一个单倍体基因组。精子在胚胎发生的表观遗传调控、配子融合和卵裂中起着至关重要的作用,这可能会影响卵胞浆内单精子注射的结果。

目的

研究父亲年龄、射精禁欲时间和精液参数是否影响卵母细胞共享捐赠周期中卵母细胞受体的卵胞浆内单精子注射结局。

材料和方法

本回顾性队列研究纳入了 427 个卵母细胞受体卵胞浆内单精子注射周期,来自于 2015 年 1 月至 2017 年 5 月在一家私人体外受精中心进行卵母细胞共享捐赠周期的 321 名患者。回顾了供体和受体卵胞浆内单精子注射周期的电子病历。使用一般混合模型研究了男性年龄、射精禁欲时间和精液参数对受体卵胞浆内单精子注射结局的影响。种植率、妊娠率和活产率是主要的结局指标。

结果

父亲年龄对受精、第 3 天优质胚胎、第 3 天正常胚胎分裂速度、囊胚形成、优质囊胚和种植均有负面影响,与妊娠率和活产率降低有关。射精禁欲时间对第 3 天优质胚胎、第 3 天正常胚胎发育、囊胚发育和种植有负面影响。精子计数对受精、囊胚发育和种植有正面影响。前向运动精子的百分比对第 3 天正常胚胎发育率和种植率有正面影响。总活动精子计数对囊胚发育率和种植率有正面影响。

讨论与结论

应该进一步研究男性特征对卵胞浆内单精子注射结局的影响。父亲年龄是不可控的,但减少射精禁欲时间可能是改善卵胞浆内单精子注射结局的替代方法。

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