Department of Assisted Reproduction, the Ninth People's Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2024 May 15;15:1364285. doi: 10.3389/fendo.2024.1364285. eCollection 2024.
Although the effectiveness of pentoxifylline (PF) as a selective inhibitor of phosphodiesterase to enhance sperm motility through increasing cyclic nucleotide in cases of absolute asthenozoospermia has been demonstrated for ICSI, data related to babies born from the PF-ICSI are still severely lacking. Concerns have been raised regarding the potential embryotoxicity of PF due to the controversial results obtained from the analysis of this compound on animal embryo development. This study aimed to determine whether the application of PF to trigger frozen-thawed TESA (testicular sperm aspiration) spermatozoa increases the risk of adverse obstetric and neonatal outcomes compared with non-PF frozen-thawed TESA ICSI and conventional ICSI using fresh ejaculation.
A total of 5438 patients were analyzed in this study, including 240 patients underwent PF-TESA ICSI (ICSI using PF triggered frozen-thawed testicular spermatozoa), 101 patients underwent non-PF TESA ICSI (ICSI using frozen-thawed testicular spermatozoa) and 5097 patients underwent conventional ICSI using fresh ejaculation. Propensity score matching was executed to control the various characteristics of patients.
No significant differences in pregnancy outcomes were observed among the three groups (PF-TESA ICSI, non-PF TESA ICSI and conventional ICSI), including biochemical pregnancy, clinical pregnancy, implantation, miscarriage, ectopic pregnancy, multiple pregnancy, and live birth, following propensity score matching. Additionally, neonatal outcomes were found to be similar among the three groups, with no statistical differences observed in the birth defect, birth weight, gestational age, preterm birth, and early-neonatal death.
PF-ICSI may be an alternative treatment in patients using frozen-thawed testicular spermatozoa, resulting in comparable pregnancy and neonatal outcomes.
尽管己烯雌酚（PF）作为磷酸二酯酶的选择性抑制剂通过增加环核苷酸在绝对弱精症的情况下提高精子活力的有效性已在 ICSI 中得到证实，但与 PF-ICSI 出生的婴儿相关的数据仍然严重缺乏。由于对该化合物在动物胚胎发育上的分析结果存在争议，人们对 PF 潜在的胚胎毒性提出了担忧。本研究旨在确定与非 PF 冻融 TESA（睾丸精子抽吸）ICSI 和使用新鲜射出精液的常规 ICSI 相比，应用 PF 触发冻融 TESA 精子是否会增加不良产科和新生儿结局的风险。
本研究共分析了 5438 例患者，包括 240 例行 PF-TESA ICSI（使用 PF 触发冻融睾丸精子的 ICSI）、101 例行非 PF TESA ICSI（使用冻融睾丸精子的 ICSI）和 5097 例行使用新鲜射出精液的常规 ICSI。执行倾向评分匹配以控制患者的各种特征。
在倾向评分匹配后，三组（PF-TESA ICSI、非 PF TESA ICSI 和常规 ICSI）之间的妊娠结局无显著差异，包括生化妊娠、临床妊娠、着床、流产、异位妊娠、多胎妊娠和活产。此外，三组新生儿结局相似，出生缺陷、出生体重、胎龄、早产和早期新生儿死亡无统计学差异。
PF-ICSI 可能是使用冻融睾丸精子的患者的一种替代治疗方法，可获得相似的妊娠和新生儿结局。
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