Friedler S, Raziel A, Soffer Y, Strassburger D, Komarovsky D, Ron-el R
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
Fertil Steril. 1997 Nov;68(5):892-7. doi: 10.1016/s0015-0282(97)00358-0.
To compare the outcome of intracytoplasmic sperm injection (ICSI) with fresh and frozen-thawed testicular spermatozoa in patients with nonobstructive azoospermia.
Retrospective analysis of consecutive ICSI cycles.
In Vitro Fertilization Unit, Assaf Harofeh Medical Center.
PATIENT(S): Eighteen with nonobstructive azoospermia in whom testicular sperm was found after testicular sperm extraction.
INTERVENTION(S): Testicular sperm retrieval, cryopreservation, and ICSI with fresh or frozen-thawed testicular spermatozoa.
MAIN OUTCOME MEASURE(S): Two-pronuclear fertilization; embryo cleavage rates, mean number of embryos transferred per cycle, and their relative quality, embryo implantation, clinical pregnancy, and ongoing pregnancy rates (PRs) per ET.
RESULT(S): No statistically significant differences were noted in all parameters examined between ICSI cycles with fresh or cryopreserved testicular spermatozoa from the same nine patients and comparing all ICSI cycles performed; with fresh (25 cycles) and thawed (14 cycles) testicular spermatozoa, respectively: two-pronuclear fertilization, 47% versus 44%; embryo cleavage rates, 94% versus 89%; implantation rates, 9% versus 11%; and clinical PR, 26% versus 27%. The delivery or ongoing PR using fresh sperm was better (21% versus 9%), but the difference did not reach statistical significance. The cumulative clinical PRs and ongoing PRs per testicular sperm extraction procedure were 36% and 24%, respectively.
CONCLUSION(S): Testicular sperm cryopreservation using a simple freezing protocol is promising in patients with nonobstructive azoospermia augmenting the overall success achieved after surgical sperm retrieval.
比较非梗阻性无精子症患者采用新鲜和冻融睾丸精子进行卵胞浆内单精子注射（ICSI）的结局。
对连续的ICSI周期进行回顾性分析。
阿萨夫·哈罗费医疗中心体外受精科。
18例非梗阻性无精子症患者，经睾丸精子提取后发现睾丸精子。
睾丸精子获取、冷冻保存，以及使用新鲜或冻融睾丸精子进行ICSI。
双原核受精；胚胎分裂率、每个周期移植胚胎的平均数量及其相对质量、胚胎着床率、临床妊娠率和每次胚胎移植的持续妊娠率（PRs）。
在对来自相同9例患者的新鲜或冷冻保存睾丸精子的ICSI周期进行比较，以及对所有进行的ICSI周期（分别使用新鲜（25个周期）和解冻（14个周期）睾丸精子）进行比较时，在所检查的所有参数中均未发现统计学上的显著差异：双原核受精，分别为47%和44%；胚胎分裂率，分别为94%和89%；着床率，分别为9%和11%；临床PR，分别为26%和27%。使用新鲜精子的分娩或持续PR更好（分别为21%和9%），但差异未达到统计学意义。每次睾丸精子提取程序的累积临床PR和持续PR分别为36%和24%。
对于非梗阻性无精子症患者，采用简单冷冻方案进行睾丸精子冷冻保存有望提高手术获取精子后的总体成功率。
