Department of Human Reproduction, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Department of Human Reproduction, Division of Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Reprod Biomed Online. 2021 Feb;42(2):391-399. doi: 10.1016/j.rbmo.2020.09.021. Epub 2020 Sep 28.
Does the site of semen collection influence IVF/intracytoplasmic sperm injection (ICSI) cycle outcome?
Retrospective study performed at the University Medical Centre Ljubljana, including all stimulated and modified natural IVF/ICSI cycles (with at least one oocyte retrieved) performed in 2019 with fresh ejaculated semen samples. IVF/ICSI cycle outcomes, in terms of oocytes, embryos and pregnancy rates according to site of semen sample collection (at home or at clinic) were evaluated.
Samples collected at clinic had significantly lower sperm concentration (median [interquartile range, IQR], 50 [20-100] million/ml versus 70 [30-100] million/ml, adjusted odds ratio [OR] 0.001, 95% confidence interval [CI] 1.574 × 10 to 0.196, P = 0.012) and motility (60 [50-70]% versus 70 [50-70]%, adjusted OR 0.034, 95% CI 0.002 to 0.563, P = 0.018, adjusted for age). There was no difference in total sperm count, semen volume or sperm morphology, or women's age (36 [32-39] versus 36 [33-39] years) and men's age (37 [34-41] versus 38 [34-42] years), between semen samples collected at clinic versus at home. When all IVF/ICSI cycles were analysed together using generalized estimating equation analysis, no significant difference in cycle outcomes attributed to site of semen sample collection was observed. There were also no significant differences in cycle outcomes when only first cycles were analysed.
Collecting semen samples at home has a positive effect on sperm quality (sperm concentration and motility were higher), but no significant differences in cycle outcomes are observed when these samples are used in IVF/ICSI cycles. Therefore, it is suggested that collecting semen samples at home for IVF/ICSI procedures is safe and has no negative effect on treatment outcomes.
精液采集地点是否会影响体外受精/卵胞浆内单精子注射(ICSI)周期的结果?
这是在卢布尔雅那大学医学中心进行的回顾性研究,纳入了 2019 年所有接受刺激和改良自然体外受精/ICSI 周期(至少取出一个卵母细胞)的患者,这些周期均使用新鲜射出的精液样本。根据精液样本采集地点(在家或在诊所)评估体外受精/ICSI 周期的卵母细胞、胚胎和妊娠率等结果。
在诊所采集的样本精子浓度明显较低(中位数[四分位距,IQR]:50 [20-100]百万/ml 比 70 [30-100]百万/ml,调整后的优势比[OR]:0.001,95%置信区间[CI]:1.574×10 -1 至 0.196,P = 0.012)和活力(60 [50-70]%比 70 [50-70]%,调整后的 OR:0.034,95%CI:0.002 至 0.563,P = 0.018,校正年龄后)。总精子计数、精液量或精子形态以及女性年龄(36 [32-39]岁比 36 [33-39]岁)和男性年龄(37 [34-41]岁比 38 [34-42]岁)在诊所和家中采集的精液样本之间没有差异。当使用广义估计方程分析一起分析所有体外受精/ICSI 周期时,未观察到精液样本采集地点对周期结果的显著影响。仅分析第一个周期时,周期结果也没有显著差异。
在家采集精液样本对精子质量有积极影响(精子浓度和活力更高),但在体外受精/ICSI 周期中使用这些样本时,周期结果没有显著差异。因此,建议在家中采集精液样本用于体外受精/ICSI 程序是安全的,并且对治疗结果没有负面影响。