Kahraman S, Tasdemir M, Tasdemir I, Vicdan K, Ozgur S, Polat G, Islk A Z, Biberoğlu K, Vanderzwalmen P, Nijs M, Schoysman R
Assisted Reproductive Techniques and Reproductive Endocrinology Unit, Sevgi Hospital, Ankara, Turkey.
Hum Reprod. 1996 Jun;11(6):1343-6. doi: 10.1093/oxfordjournals.humrep.a019384.
The efficacy of intracytoplasmic sperm injection (ICSI) employing testicular and ejaculated spermatozoa was assessed in 24 couples with totally or initially immotile spermatozoa. No criteria were employed in selecting which patients would be treated with testicular or ejaculated spermatozoa. The men were chosen at random. Testicular spermatozoa obtained by testicular sperm extraction were used in 14 and ejaculated spermatozoa were used in 10 of these couples. In all cases. asthenozoospermia was total in their basal semen sample. In 12 male partners, spermatozoa were totally immotile before and after Percoll gradient fractionation (totally immotile). In the remaining 12 men, spermatozoa initially showed a total absence of motility; however, some of the spermatozoa had showed very poor motility (0. 1%) after Percoll gradient fractionation and a 1.5-2.0 h incubation period (initially immotile). Of these 24 total asthenozoospermic males, 14 also had total teratozoospermia. The fertilization and cleavage rates in the testicular and ejaculated sperm groups were 53. 5 and 96.3 and 54.5 and 94.4% respectively. One cycle resulted in complete fertilization failure, and in 23 embryo transfer cycles a total of 10 pregnancies were obtained (41.6%). Eight pregnancies were achieved in the testicular sperm group, while only two pregnancies were obtained in the ejaculated sperm group. Four pregnancies, two from the ejaculated sperm group and two from the testicular sperm group, resulted in clinical abortions in the first trimester. Of the remaining six pregnancies, two have already resulted in healthy births and four pregnancies are now in the second or third trimester in the testicular sperm group. Using testicular spermatozoa in combination with ICSI can be an alternative mode of treatment in cases with totally or initially immotile spermatozoa in the ejaculate. Very low pregnancy rates have been obtained and no ongoing pregnancy has been achieved using ejaculated spermatozoa in these cases.
对24对精子完全或最初无活力的夫妇评估了采用睾丸精子和射出精子进行卵胞浆内单精子注射（ICSI）的疗效。在选择哪些患者使用睾丸精子或射出精子进行治疗时未采用任何标准。这些男性是随机挑选的。其中14对夫妇使用通过睾丸精子提取获得的睾丸精子，10对夫妇使用射出精子。在所有病例中，其基础精液样本均为完全弱精子症。12名男性伴侣的精子在Percoll梯度分级分离前后完全无活力（完全无活力）。在其余12名男性中，精子最初完全无活力；然而，一些精子在Percoll梯度分级分离和1.5 - 2.0小时孵育期后显示出非常差的活力（0.1%）（最初无活力）。在这24名完全弱精子症男性中，14名还患有完全畸形精子症。睾丸精子组和射出精子组的受精率和卵裂率分别为53.5%和96.3%以及54.5%和94.4%。一个周期导致完全受精失败，在23个胚胎移植周期中共获得10次妊娠（41.6%）。睾丸精子组获得8次妊娠，而射出精子组仅获得2次妊娠。4次妊娠，2次来自射出精子组，2次来自睾丸精子组，在孕早期发生临床流产。在其余6次妊娠中，2次已产下健康婴儿，睾丸精子组的4次妊娠目前处于孕中期或晚期。对于射精中精子完全或最初无活力的病例，将睾丸精子与ICSI联合使用可能是一种替代治疗方式。在这些病例中，使用射出精子获得的妊娠率非常低，且未获得正在进行的妊娠。
