Lee Jisun, Yoo Jung Hyeon, Lee Jae Hun, Ahn Hyun Soo, Hwang Kyung Joo, Kim Miran
Department of Obstetrics and Gynecology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Obstetrics and Gynecology, Bundang Jaeseng Hospital, Seongnam, Korea.
Yeungnam Univ J Med. 2021 Jan;38(1):53-59. doi: 10.12701/yujm.2020.00773. Epub 2020 Dec 9.
There are no guidelines for the optimal incubation time or temperature to improve pregnancy outcomes in testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) cycles. We aimed to evaluate whether a 24-hour in vitro culture of testicular spermatozoa affects pregnancy outcomes in TESE-ICSI cycles.
This was a retrospective study of 83 TESE-ICSI cycles using testicular spermatozoa in 46 couples with male partners suffering from nonobstructive or obstructive azoospermia. Sperm retrieval was performed either on the oocyte retrieval (OR) day (65 cycles in 33 couples; group A) or on the day before OR (18 cycles in 13 couples; group B) followed by in vitro culture for 24 hours. The clinical characteristics and pregnancy outcomes, including the number of retrieved oocytes, fertilization rates, embryo transfer rates, implantation and clinical pregnancy rates, were compared between the two groups.
There were no differences in terms of clinical characteristics except for the levels of luteinizing hormone (LH) in males. Group B had higher LH levels than group A (4.56±1.24 IU/L vs. 3.67±1.07 IU/L, p=0.017). Group B showed higher fertilization rate (72.4±32.1% vs. 59.2±21.7%, p=0.045), implantation rate (35.0±34.1% vs. 14.0±21.5%, p=010), pregnancy rate per cycle (80% vs. 39%, p=0.033), and clinical pregnancy rate per cycle (80% vs. 37.5%, p=0.024) than those of group A.
Testicular sperm retrieval performed on the day before OR followed by in vitro culture can potentially improve pregnancy outcomes.
对于睾丸精子提取-卵胞浆内单精子注射（TESE-ICSI）周期中，尚无关于最佳孵育时间或温度以改善妊娠结局的指南。我们旨在评估睾丸精子体外培养24小时是否会影响TESE-ICSI周期的妊娠结局。
这是一项对46对夫妇进行的回顾性研究，这些夫妇的男性伴侣患有非梗阻性或梗阻性无精子症，共进行了83个使用睾丸精子的TESE-ICSI周期。精子采集在取卵（OR）日（33对夫妇中的65个周期；A组）或OR前一天（13对夫妇中的18个周期；B组）进行，随后进行24小时的体外培养。比较两组的临床特征和妊娠结局，包括回收的卵母细胞数量、受精率、胚胎移植率、着床率和临床妊娠率。
除男性黄体生成素（LH）水平外，两组临床特征无差异。B组LH水平高于A组（4.56±1.24 IU/L对3.67±1.07 IU/L，p = 0.017）。B组的受精率（72.4±32.1%对59.2±21.7%，p = 0.045）、着床率（35.0±34.1%对14.0±21.5%，p = 0.010）、每个周期的妊娠率（80%对39%，p = 0.033）和每个周期的临床妊娠率（80%对37.5%，p = 0.024）均高于A组。
在OR前一天进行睾丸精子采集并随后进行体外培养可能会改善妊娠结局。
