两篇后续的开创性成果：治疗非常严重的少精弱精症不育夫妇的良好策略。

Two subsequent seminal productions: A good strategy to treat very severe oligoasthenoteratozoospermic infertile couples.

机构信息

Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

出版信息

Andrology. 2021 Jul;9(4):1185-1191. doi: 10.1111/andr.13020. Epub 2021 Apr 28.

DOI:10.1111/andr.13020

PMID:33861504

Abstract

BACKGROUND

Sexual abstinence is considered one of the several factors that influence sperm quality. Recent studies show that a shortening of the abstinence period could be beneficial mostly in oligoasthenoteratozoospermic (OAT) patients.

OBJECTIVE

Retrospective study to verify the efficacy of a second semen sample after a short abstinence to treat severe OAT infertile patients.

MATERIALS AND METHODS

127 couples treated between May 2014 and May 2018 were divided into two groups. Study Group 1 (75 cycles): severe OAT characteristics: count <0.2 × 10 /mL no progressive motility; count ≥0.2 × 10 /mL and no total or progressive motility; 0% normal morphology; a second semen sample was requested after abstinence of 2 h. Control Group 0 (52 cycles): normozoospermic or mild OAT; only one sample was requested. Intracytoplasmic sperm injection was utilized in all cases.

RESULTS

All semen parameters were significantly different between Group 0 vs both samples of Group 1 (p < 0.001), excluding volume between Group 0 and 1st sample of Group 1 (p = 0.682). The comparison between 1st and 2nd samples from Group 1 showed significant differences in volume, total and progressive motility and morphology (p < 0.001, p < 0.001, p < 0.020) but not in total sperm count (p = 0.970). Fertilization, pregnancy rate/transfer, implantation and miscarriage rates were 85.9% and 61.1% (p < 0.001), 30.6% and 35.8% (p = 0.700), 17.5% and 24.0 (p = 0.292), 20.0% and 25.0% (p = 0.017) in Group 0 and Group 1 respectively.

DISCUSSION AND CONCLUSION

The results show that a short abstinence in severe OAT patients allows us to obtain spermatozoa with better motility. The request for a second semen sample in couples with extreme semen parameters is a valid and simple strategy that helps to achieve the same probability of pregnancy compared to a Control Group. Furthermore, it allows us to utilize fresh spermatozoa avoiding the need to resort to cryopreserved reserves or testicular surgery.

摘要

背景

禁欲被认为是影响精子质量的几个因素之一。最近的研究表明，缩短禁欲期可能对少精弱精症（OAT）患者有益。

目的

回顾性研究验证第二次精液样本在短禁欲后治疗严重 OAT 不育患者的疗效。

材料和方法

2014 年 5 月至 2018 年 5 月期间，将 127 对夫妇分为两组。研究组 1（75 个周期）：严重 OAT 特征：计数<0.2×10/ml，无渐进性运动；计数≥0.2×10/ml 且无总运动或渐进性运动；形态正常 0%；要求禁欲 2 小时后进行第二次精液样本检查。对照组 0（52 个周期）：正常精子或轻度 OAT；仅请求一个样本。所有病例均采用胞浆内精子注射。

结果

组 0 与组 1 的两个样本之间的所有精液参数均有显著差异（p<0.001），但组 0 与组 1 的第一次样本之间的体积无显著差异（p=0.682）。组 1 的第一次和第二次样本之间的比较显示，体积、总运动和渐进性运动以及形态有显著差异（p<0.001，p<0.001，p<0.020），但总精子计数无显著差异（p=0.970）。受精率、妊娠率/移植率、植入率和流产率分别为 85.9%和 61.1%（p<0.001），30.6%和 35.8%（p=0.700），17.5%和 24.0%（p=0.292），20.0%和 25.0%（p=0.017），组 0 和组 1 分别。