Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.
Andrologia. 2022 Jul;54(6):e14403. doi: 10.1111/and.14403. Epub 2022 Mar 1.
Leukocytospermia is one of the common causes of male infertility, and its effects on the clinical outcomes of assisted reproduction are controversial. There are no recommendations for the management of leukocytospermia in cases of assisted reproductive technology (ART). To investigate the impact of leukocytospermia on ART, we retrospectively compared the clinical outcomes in ART couples with or without leukocytospermia and further analysed the impact of the insemination method itself by split insemination treatment in ART couples with leukocytospermia. In this study, leukocytospermia was detected in 133 patients, namely 63 in the conventional in vitro fertilization (IVF) group, 38 in the intracytoplasmic sperm injection (ICSI) group and 32 in the split insemination group. Leukocytospermia has a negative influence on the parameters of semen samples; however, leukocytospermia did not affect the clinical outcomes of IVF or ICSI. Different insemination methods did not affect the fertilization, clinical pregnancy or live birth rates. In the split insemination study, no significant differences in clinical pregnancy and live birth rates between the IVF and ICSI groups were found; however, the numbers of two pronuclei (2PN), available embryos and good-quality embryos in the ICSI group were higher than those in the IVF group. Leukocytospermia may be a risk factor affecting semen parameters, and more attention should be given to IVF insemination. Leukocytospermia has no significant negative effect on the outcomes of ART. ICSI may obtain better embryos than IVF, but it cannot improve the clinical pregnancy and live birth rates.
白细胞精子症是男性不育的常见原因之一，其对辅助生殖技术（ART）临床结局的影响存在争议。ART 中尚无白细胞精子症的管理建议。为了研究白细胞精子症对 ART 的影响，我们回顾性比较了白细胞精子症和非白细胞精子症的 ART 夫妇的临床结局，并进一步通过白细胞精子症的 ART 夫妇的分割授精治疗分析了授精方法本身的影响。在这项研究中，133 名患者检测出白细胞精子症，即常规体外受精（IVF）组 63 例，胞浆内单精子注射（ICSI）组 38 例，分割授精组 32 例。白细胞精子症对精液样本参数有负面影响；然而，白细胞精子症并不影响 IVF 或 ICSI 的临床结局。不同的授精方法不影响受精、临床妊娠或活产率。在分割授精研究中，IVF 和 ICSI 组的临床妊娠率和活产率无显著差异；然而，ICSI 组的二倍体（2PN）、可利用胚胎和优质胚胎数量均高于 IVF 组。白细胞精子症可能是影响精液参数的危险因素，应更加关注 IVF 授精。白细胞精子症对 ART 的结局没有显著的负面影响。ICSI 可能比 IVF 获得更好的胚胎，但不能提高临床妊娠率和活产率。
