Johnston R C, Kovacs G T, Lording D H, Baker H W
Andrology Laboratory, Prince Henry's Institute of Medical Research, Monash Medical Centre, Clayton, Victoria, Australia.
Fertil Steril. 1994 Feb;61(2):355-9. doi: 10.1016/s0015-0282(16)56531-5.
To determine the validity of the criteria currently used to select fertile sperm donors.
Retrospective study of the outcome of donor insemination treatment cycles over a 15-year period.
The Reproductive Medicine Clinic of Prince Henry's Institute of Medical Research (formerly Medical Research Centre, Prince Henry's Hospital, South Melbourne, Victoria, Australia).
Couples (1,299) presented with severe male factor infertility (azoospermia or severe oligozoospermia) and were treated by donor insemination (10,796 treatment cycles) using cryopreserved semen from 292 normal healthy men aged between 18 and 46 years as sperm donors.
Semen characteristics, including volume, count, motility, motility index, normal morphology, live cells, and post-thaw motility, were analyzed by logistic regression analysis to determine which groups of factors were related independently and significantly to pregnancy rates.
The pregnancy rate for donor insemination was 8.9% per cycle. By logistic regression count, normal morphology, post-thaw motility (%), and post-thaw motility index together explained 28% of the variance of the pregnancy rates. Other factors, including prethaw motility characteristics (percent motility and motility index), donor age, weight, LH, FSH, and T levels, were not significant.
The standard parameters of sperm count, morphology, and post-thaw motility are the most important factors for the selection of highly fertile donors. As most of the variability in the pregnancy rates resulted from other undetermined factors related both to the donor and the recipient, it is suggested that the pragmatic approach of discarding donors after a reasonable number of treatment failures (20 to 50) should continue.
确定当前用于选择可育精子捐献者的标准的有效性。
对15年期间供精人工授精治疗周期结果的回顾性研究。
亨利王子医学研究所生殖医学诊所（原澳大利亚维多利亚州南墨尔本亨利王子医院医学研究中心）。
1299对夫妇，患有严重男性因素不孕症（无精子症或严重少精子症），接受了供精人工授精治疗（10796个治疗周期），使用来自292名年龄在18至46岁之间的正常健康男性的冷冻精液作为精子捐献者。
通过逻辑回归分析对精液特征进行分析，包括体积、计数、活力、活力指数、正常形态、活细胞及解冻后活力，以确定哪些因素组与妊娠率独立且显著相关。
供精人工授精的妊娠率为每个周期8.9%。通过逻辑回归分析，计数、正常形态、解冻后活力（%）和解冻后活力指数共同解释了妊娠率变异的28%。其他因素，包括解冻前活力特征（活力百分比和活力指数）、捐献者年龄、体重、促黄体生成素、促卵泡生成素和睾酮水平，均无显著意义。
精子计数、形态及解冻后活力的标准参数是选择高生育力捐献者的最重要因素。由于妊娠率的大部分变异来自与捐献者和接受者相关的其他未确定因素，建议在合理数量（20至50次）的治疗失败后放弃捐献者的务实做法应继续沿用。
