Department of Andrology, Center for Men's Health, Shanghai General Hospital, Shanghai Key Lab of Reproductive Medicine, Shanghai, People's Republic of China.
Human Sperm Bank, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, People's Republic of China.
Andrology. 2022 Jan;10(1):82-91. doi: 10.1111/andr.13091. Epub 2021 Aug 24.
Systematic reviews have focused on sperm recovery and post-thaw parameters after cryopreservation, but there is no information on the associated clinical outcomes. In recent years, an increasing number of studies have reported cryopreservation of a single sperm due to the importance of fertility preservation.
To assess whether the cryopreservation of single human spermatozoa improves clinical outcomes in patients with azoospermia or severe oligospermia.
We conducted an extensive literature search using the following databases: CENTRAL, CNKI, Cochrane Systematic Reviews, EMBASE, MEDLINE, PUBMED, and Web of Science for relevant studies published through December 31, 2019. We calculated the pooled proportions of cryopreservation of a single human spermatozoon to assess the recovery, survival, fertilization, pregnancy, miscarriage, and delivery rates. Subgroup analyses were performed for the following covariates, (a) different carriers, (b) year of publication, and (c) source of sperm.
We included 25 studies, which included 13 carriers. The pooled proportion of recovery rate of spermatozoa cryopreserved was 92% (95% CI, 87%-96%), and the survival, fertilization, pregnancy, miscarriage, and delivery rates were 76% (95% CI, 69%-83%), 63% (95% CI, 58%-67%), 57% (95% CI, 39%-74%), 12% (95% CI, 0%-33%), and 40% (95% CI, 12%-71%), respectively. Based on the subgroup analysis, the recovery and survival rates of frozen spermatozoa in a subgroup of different carriers were statistically significant. In the past decade, frozen single human spermatozoon technology has improved the recovery rates of frozen-thawed spermatozoa. However, the differences in clinical outcomes of frozen spermatozoa in subgroups of different sources of sperm were not statistically significant.
The techniques for single human spermatozoa are feasible and efficient and may benefit patients with severe oligospermia or azoospermia.
系统评价主要集中在精子回收和冷冻保存后的解冻参数上，但没有关于相关临床结果的信息。近年来，由于生育力保存的重要性，越来越多的研究报告了单个精子的冷冻保存。
评估人类单个精子的冷冻保存是否能改善无精子症或严重少精子症患者的临床结局。
我们使用以下数据库进行了广泛的文献检索：CENTRAL、CNKI、Cochrane 系统评价、EMBASE、MEDLINE、PUBMED 和 Web of Science，以检索截至 2019 年 12 月 31 日发表的相关研究。我们计算了单个人类精子冷冻保存的回收率，以评估复苏、存活、受精、妊娠、流产和分娩率。进行了以下协变量的亚组分析：(a) 不同载体，(b) 出版年份，和(c) 精子来源。
我们纳入了 25 项研究，其中包括 13 个载体。精子冷冻保存的回收率为 92%（95%置信区间，87%-96%），存活率、受精率、妊娠率、流产率和分娩率分别为 76%（95%置信区间，69%-83%）、63%（95%置信区间，58%-67%）、57%（95%置信区间，39%-74%）、12%（95%置信区间，0%-33%）和 40%（95%置信区间，12%-71%）。基于亚组分析，不同载体亚组中冷冻精子的回收率和存活率有统计学意义。在过去十年中，冷冻单个人类精子技术提高了冷冻精子的回收率。然而，不同精子来源亚组中冷冻精子的临床结局差异无统计学意义。
单个人类精子技术是可行和有效的，可能有益于严重少精子症或无精子症患者。
