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冻卵供体体外受精(IVF)周期中使用新鲜精子与冷冻精子的结局比较。

Outcomes of Frozen Oocyte Donor In Vitro Fertilization (IVF) Cycles Using Fresh Versus Frozen Sperm.

机构信息

Division of Reproductive Endocrinology and Infertility, Mayo Clinic, 200 First Street SW, Rochester, MN, 55901, USA.

Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA.

出版信息

Reprod Sci. 2022 Apr;29(4):1226-1231. doi: 10.1007/s43032-021-00796-9. Epub 2021 Nov 23.

DOI:10.1007/s43032-021-00796-9
PMID:34816374
Abstract

The ability to use frozen sperm for insemination during in vitro fertilization (IVF) is crucial for patients and for reproductive endocrinologists. However, concerns exist regarding the effects of cryopreservation on sperm quality and IVF outcomes. This study compares outcomes of frozen donor oocyte IVF cycles with intracytoplasmic sperm injection (ICSI) of good quality fresh versus frozen ejaculated sperm. Patients who underwent their first frozen donor oocyte IVF cycle between 2013 and 2019 at Mayo Clinic were identified. The primary outcome was live birth rate (LBR). Secondary outcomes included fertilization rate (FR), blastocyst development rate (BR), and clinical pregnancy rate (CPR). Twenty-six patients used fresh sperm and 19 patients utilized frozen sperm; there were no significant demographic differences between the groups. There were no significant differences noted in CPR, FR, and BR. Although the LBR was not statistically different when frozen versus fresh sperm was utilized (52.6% vs. 61.5%, p = 0.55), there was a distinct trend towards improved outcomes with fresh sperm that may be clinically significant. This data suggests that frozen sperm may be an alternative to a fresh sample, however fresh sperm may ultimately be a better option. This finding should be further explored with studies utilizing a larger sample size.

摘要

在体外受精 (IVF) 中使用冷冻精子进行授精的能力对患者和生殖内分泌学家至关重要。然而,人们对冷冻对精子质量和 IVF 结果的影响存在担忧。本研究比较了优质新鲜与冷冻射出精子的胞浆内精子注射 (ICSI) 冷冻供体卵母细胞 IVF 周期的结果。在梅奥诊所,2013 年至 2019 年期间,确定了接受首次冷冻供体卵母细胞 IVF 周期的患者。主要结局是活产率 (LBR)。次要结局包括受精率 (FR)、囊胚发育率 (BR) 和临床妊娠率 (CPR)。26 名患者使用新鲜精子,19 名患者使用冷冻精子;两组之间没有显著的人口统计学差异。CPR、FR 和 BR 无显著差异。虽然使用冷冻与新鲜精子时 LBR 没有统计学差异(52.6% vs. 61.5%,p=0.55),但新鲜精子的结局明显改善,这可能具有临床意义。该数据表明,冷冻精子可能是新鲜样本的替代方案,但新鲜精子最终可能是更好的选择。这一发现应通过更大样本量的研究进一步探讨。

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本文引用的文献

1
Does conventional freezing affect sperm DNA fragmentation?传统冷冻会影响精子DNA片段化吗?
Clin Exp Reprod Med. 2019 Jun;46(2):67-75. doi: 10.5653/cerm.2019.46.2.67. Epub 2019 Jun 1.
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Impact of male partner characteristics and semen parameters on in vitro fertilization and obstetric outcomes in a frozen oocyte donor model.在冷冻卵母细胞捐赠者模型中,男性伴侣特征和精液参数对体外受精和产科结局的影响。
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儿童和青少年的生育力保存:现状与未来。
Curr Urol Rep. 2024 Jul;25(7):133-140. doi: 10.1007/s11934-024-01204-w. Epub 2024 May 10.
通过延时显微镜观察到的早期胚胎发育是否取决于用于卵胞浆内单精子注射(ICSI)的精子是新鲜的还是冷冻的?一项队列研究。
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Reprod Biomed Online. 2015 Feb;30(2):120-7. doi: 10.1016/j.rbmo.2014.10.018. Epub 2014 Nov 13.
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Analysis of the outcome of intracytoplasmic sperm injection using fresh or frozen sperm.分析使用新鲜或冷冻精子进行胞浆内单精子注射的结果。
BJU Int. 2011 Apr;107(7):1124-8. doi: 10.1111/j.1464-410X.2010.09545.x.
6
Intracytoplasmic sperm injection (ICSI) using cryopreserved sperm from men with malignant neoplasm yields high pregnancy rates.使用患有恶性肿瘤男性的冷冻精子进行胞浆内单精子注射(ICSI)可获得较高的妊娠率。
Fertil Steril. 2008 Sep;90(3):557-63. doi: 10.1016/j.fertnstert.2007.03.002. Epub 2008 Aug 9.
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Fertilization and pregnancy outcome after intracytoplasmic injection with fresh or cryopreserved ejaculated spermatozoa.新鲜或冷冻保存的射出精子胞浆内注射后的受精及妊娠结局
Fertil Steril. 2007 Feb;87(2):316-20. doi: 10.1016/j.fertnstert.2006.06.032. Epub 2006 Nov 1.
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Sperm deoxyribonucleic acid fragmentation as a prognostic indicator of assisted reproductive technology outcome.精子脱氧核糖核酸碎片作为辅助生殖技术结局的预后指标。
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Sperm cryopreservation in oncological patients: a 14-year follow-up study.肿瘤患者精子冷冻保存:一项14年的随访研究。
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DNA fragmentation of spermatozoa and assisted reproduction technology.精子DNA碎片化与辅助生殖技术
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