Gil-Salom M, Romero J, Minguez Y, Rubio C, De los Santos M J, Remohí J, Pellicer A
Instituto Valenciano de Infertilidad, Guardia Civil 23, E-46020 Valencia, Spain.
Hum Reprod. 1996 Jun;11(6):1309-13. doi: 10.1093/oxfordjournals.humrep.a019377.
In 25 patients (14 suffering from obstructive azoospermia, six from non-obstructive azoospermia, three from asthenoazoospermia and two from absence of ejaculation) spermatozoa were extracted from testicular biopsies. Intracytoplasmic sperm injection (ICSI) with fresh testicular spermatozoa was performed in 18 cases; spermatozoa in excess were cryopreserved in pills. No pregnancies were achieved. In the remaining seven patients, testicular spermatozoa were retrieved and cryopreserved during a diagnostic testicular biopsy. After thawing, sperm motility was assessed in 17 cases (68%), and 18 ICSI with cryopreserved testicular spermatozoa were performed. The mean two-pronuclear (2PN) fertilization rate was 59%, the mean cleavage rate was 92%, and six clinical pregnancies were achieved, all of them still ongoing (pregnancy rate 33%). A comparison of the results of ICSI carried out with fresh or cryopreserved testicular spermatozoa showed that the mean 2PN fertilization rates per cycle (53 compared with 55%), mean cleavage rates per cycle (99 compared with 96%) and embryo quality were not significantly different. In conclusion, cryopreservation of testicular spermatozoa is feasible, even in patients with non-obstructive azoospermia, and the results of ICSI with frozen-thawed testicular spermatozoa are similar to those obtained using fresh testicular spermatozoa. Cryopreservation of testicular spermatozoa may avoid repetition of testicular biopsies to retrieve spermatozoa for successive ICSI cycles in patients in whom the only source of motile spermatozoa is the testicle.
在25例患者中（14例梗阻性无精子症、6例非梗阻性无精子症、3例弱精子症和2例不射精症），从睾丸活检组织中提取精子。18例患者使用新鲜睾丸精子进行了卵胞浆内单精子注射（ICSI）；多余的精子制成丸剂冷冻保存。未获得妊娠。其余7例患者在诊断性睾丸活检时获取并冷冻保存了睾丸精子。解冻后，对17例（68%）患者的精子活力进行了评估，并使用冷冻保存的睾丸精子进行了18次ICSI。平均双原核（2PN）受精率为59%，平均卵裂率为92%，获得了6例临床妊娠，均仍在继续（妊娠率33%）。对使用新鲜或冷冻保存的睾丸精子进行ICSI的结果进行比较，结果显示每个周期的平均2PN受精率（分别为53%和55%）、每个周期的平均卵裂率（分别为99%和96%）以及胚胎质量均无显著差异。总之，睾丸精子冷冻保存是可行的，即使对于非梗阻性无精子症患者也是如此，并且使用冻融睾丸精子进行ICSI的结果与使用新鲜睾丸精子获得的结果相似。对于唯一可活动精子来源为睾丸的患者，睾丸精子冷冻保存可避免为后续ICSI周期重复进行睾丸活检以获取精子。
