Suleymanova Lala, Bayram Hale, Dönmez Çakıl Yaprak, Selam Belgin, Cincik Mehmet
Institute of Graduate Studies Clinical Embryology Master Program, Maltepe University, Istanbul, Turkey.
Department of Histology and Embryology, Faculty of Medicine, Maltepe University, Istanbul, Turkey.
J Assist Reprod Genet. 2024 Dec;41(12):3399-3404. doi: 10.1007/s10815-024-03291-7. Epub 2024 Oct 21.
The relative merits of fresh or frozen testicular sperm in ICSI remain a matter of contention. This study aims to compare the reproductive outcomes of non-obstructive azoospermia patients undergoing ICSI using fresh and frozen-thawed microdissection testicular sperm extraction (micro-TESE) sperm.
A total of 223 men with non-obstructive azoospermia underwent micro-TESE to collect testicular spermatozoa. ICSI cycles were performed using fresh and frozen-thawed spermatozoa. The cleavage states and grading of embryos, fertilization, and pregnancy outcomes were compared between the groups to assess the impact of cryopreservation of testicular spermatozoa on embryo quality and ICSI outcomes.
A total of 223 cases were evaluated, with fertilization observed in 208 cases and no fertilization observed in 15 cases. The number of day 3 total embryos and the number of cleavage embryos differed between the fresh and frozen micro-TESE groups, whereas the number of two-pronuclei oocytes, grading of embryos, fertilization, pregnancy, and live birth rates were found to be similar between the two groups.
The cryopreservation of spermatozoa obtained by micro-TESE does not affect the fertilization rate or pregnancy outcome in cases of non-obstructive azoospermia. The present findings, when considered in conjunction with the extant evidence, may serve to alleviate concerns regarding the utilization of frozen-thawed micro-TESE sperm in patients with non-obstructive azoospermia.
在卵胞浆内单精子注射（ICSI）中，新鲜或冷冻睾丸精子的相对优点仍存在争议。本研究旨在比较非梗阻性无精子症患者接受ICSI时，使用新鲜和冻融后的显微切割睾丸精子提取（micro-TESE）精子的生殖结局。
共有223名非梗阻性无精子症男性接受了micro-TESE以收集睾丸精子。使用新鲜和冻融后的精子进行ICSI周期。比较两组之间胚胎的分裂状态和分级、受精情况及妊娠结局，以评估睾丸精子冷冻保存对胚胎质量和ICSI结局的影响。
共评估223例，208例观察到受精，15例未观察到受精。新鲜和冷冻micro-TESE组之间第3天的总胚胎数和分裂胚胎数不同，而两组之间双原核卵母细胞数、胚胎分级、受精、妊娠及活产率相似。
micro-TESE获得的精子冷冻保存不影响非梗阻性无精子症患者的受精率或妊娠结局。结合现有证据来看，本研究结果可能有助于减轻对非梗阻性无精子症患者使用冻融后micro-TESE精子的担忧。
