Tang Wenhao, Deng Chenyao, Gao Jiangman, Tian Senlin, Wei Nan, Li Bin, Song Jianfei, Zhang Liang, Wu Han, Jiang Hui
Department of Urology, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China.
Department of Reproductive Medicine Center, Peking University Third Hospital, Haidian District, 49 North Garden Road, Beijing, 100191, China.
Basic Clin Androl. 2022 Nov 3;32(1):18. doi: 10.1186/s12610-022-00169-5.
Sperm cryopreservation is an effective method of fertility preservation for disease-related and social sperm freezing. In total, 662 subjects (range: 15-65 years-of-age; mean: 33.49 ± 8.79 years-of-age) were included in this study to investigate the population characteristics, semen quality, and usage of autologous sperm preservation patients in Beijing. Of these, 351 were cancer patients (53.02%, 31.14 ± 7.32 years-of-age) and 311 were non-cancer patients (46.98%, 36.14 ± 9.54 years-of-age).
We found that the number of preservation cases increased steadily from 2015 to 2019; 89.73% of these had a bachelor's degree or above; 54.83%, 41.54%, and 3.63% were single, married, and divorced, respectively. The cases of cancers and oligozoospermia accounted for 71.30% of all patients; therefore, most patients required fertility preservation due to disease. The cancer group had a significantly lower sperm concentration, rate of progressive sperm after the frozen-thawed test, total progressive motility sperm count after the frozen-thawed test, and recovery rate of progressive motile sperm (RRPM) than the non-cancer group (all P < 0.05). Sperm count-related parameters were significantly affected by testicular cancer, while sperm motility-related parameters and RRPM were significantly affected by leukemia. The utilization rate of preserved sperm was 6.34% after 6 to 78 months of follow-up. In terms of fresh or frozen embryo transfer, the clinical pregnancy rate was 56.76% or 50.00%, and the live birth rate was 24.32% or 21.43%, respectively.
The need for autologous sperm preservation was dominated by patients with diseases, followed by the need for social sperm freezing. Tumors had a major negative impact on semen quality, and the usage rates of stored semen were at lower level compared to the number of sperm cryopreservation. Medical staff and patients should pay attention to both cognition-action consistency and cost-effectiveness in fertility preservation.
精子冷冻保存是一种针对疾病相关及社会因素导致的精子冷冻的有效生育力保存方法。本研究纳入了662名受试者（年龄范围：15 - 65岁；平均年龄：33.49±8.79岁），以调查北京自体精子保存患者的人群特征、精液质量及使用情况。其中，351名是癌症患者（53.02%，年龄31.14±7.32岁），311名是非癌症患者（46.98%，年龄36.14±9.54岁）。
我们发现，2015年至2019年保存病例数稳步增加；其中89.73%拥有本科及以上学历；单身、已婚和离异者分别占54.83%、41.54%和3.63%。癌症和少精子症病例占所有患者的71.30%；因此，大多数患者因疾病需要生育力保存。癌症组的精子浓度、冻融试验后的精子前向运动率、冻融试验后的总前向运动精子数以及前向运动精子回收率（RRPM）均显著低于非癌症组（所有P<0.05）。精子计数相关参数受睾丸癌影响显著，而精子活力相关参数和RRPM受白血病影响显著。随访6至78个月后，保存精子的利用率为6.34%。在新鲜或冷冻胚胎移植方面，临床妊娠率分别为56.76%或50.00%，活产率分别为24.32%或21.43%。
自体精子保存的需求以疾病患者为主，其次是社会精子冷冻的需求。肿瘤对精液质量有重大负面影响，与精子冷冻保存数量相比，储存精液的使用率处于较低水平。医护人员和患者在生育力保存中应同时关注认知 - 行动一致性和成本效益。
