Yilmaz Muserref Banu, Ozmen Sevinc
Muserref Banu Yilmaz Department of Obstetrics and Gynecology, Training and Research Hospital, University of Health Sciences, Zeynep Kamil Women and Children Diseases, Istanbul, Turkey.
Sevinc Ozmen Department of Obstetrics and Gynecology, Medipol University, Istanbul, Turkey.
Pak J Med Sci. 2025 Aug;41(8):2226-2230. doi: 10.12669/pjms.41.8.12380.
The aim of this study was to compare assisted reproduction outcome of couples with male factor and unexplained infertility.
This study is ten years of retrospective chart review of 1913 ICSI cycles performed at ART unit of a tertiary center between 2014-2023. Patients who underwent IVF due to the diagnosis of male factor infertility were included in study group (n=560). Those with unexplained infertility were added as controls (n=1353). Groups were compared in terms of cycle outcome.
Female age revealed significantly higher in control group (32.2 vs 31.0,p<0.001), while no significant difference was observed between the groups among male. While higher number of Grade-1 embryos were utilized in male factor group on 2 day, top-quality and good-quality blastocyst utilization were higher in control group. Sperm concentration and total sperm motility were significantly lower in male factor group(p<0.05), whereas mean ejaculate volume was similar. A significantly higher rate of pregnancy was observed in male factor group (36.4% vs 40.1%) while cycle cancellation was higher in the controls(p<0.001). Multivariate regression analysis revealed that positive pregnancy was significantly associated with total sperm motility and concentration after adjustment for male and female age(p<0.05). Sperm concentration was significantly associated with utilization of top-quality blastocycts (p<0.05).
Intrastoplasmic sperm injection provided worse results in progession from clevage stage to blastocycst formation in cases with male factor infertility. Analysis revealed that pregnancy outcome was significantly associated with total sperm motility. Sperm concentration was significantly associated with number of day five top-quality embryos.
本研究旨在比较男性因素不孕夫妇和不明原因不孕夫妇的辅助生殖结局。
本研究是对2014年至2023年在一家三级中心的ART科室进行的1913个ICSI周期进行的十年回顾性图表审查。因男性因素不孕诊断而接受IVF的患者被纳入研究组（n = 560）。将不明原因不孕的患者作为对照组（n = 1353）。比较两组的周期结局。
对照组女性年龄显著更高（32.2岁对31.0岁，p<0.001），而男性组之间未观察到显著差异。虽然男性因素组在第2天使用的1级胚胎数量更多，但对照组优质和良好质量囊胚的利用率更高。男性因素组的精子浓度和总精子活力显著更低（p<0.05），而平均射精量相似。男性因素组的妊娠率显著更高（36.4%对40.1%），而对照组的周期取消率更高（p<0.001）。多因素回归分析显示，在调整男女年龄后，阳性妊娠与总精子活力和浓度显著相关（p<0.05）。精子浓度与优质囊胚的利用率显著相关（p<0.05）。
对于男性因素不孕的病例，卵胞浆内单精子注射在从卵裂期到囊胚形成的过程中效果较差。分析显示，妊娠结局与总精子活力显著相关。精子浓度与第5天优质胚胎的数量显著相关。
