Madgar I, Hourvitz A, Levron J, Seidman D S, Shulman A, Raviv G G, Levran D, Bider D, Mashiach S, Dor J
Department of Urology, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Fertil Steril. 1998 Jun;69(6):1080-4. doi: 10.1016/s0015-0282(98)00076-4.
To evaluate IVF outcome after epididymal and testicular sperm retrieval in patients with obstructive or nonobstructive azoospermia.
Retrospective clinical analysis.
Public university-affiliated IVF unit.
PATIENT(S): One hundred twenty-three azoospermic patients (178 cycles).
INTERVENTION(S): Sixty-three patients (103 cycles) with obstructive azoospermia (group 1) underwent either epididymal or testicular sperm retrieval, and 60 patients (75 cycles) with nonobstructive azoospermia (group 2) underwent testicular sperm retrieval combined with IVF treatment. Mature oocytes were fertilized using intracytoplasmic sperm injection. After sperm preparation, supernumerary spermatozoa were cryopreserved.
MAIN OUTCOME MEASURE(S): Oocyte fertilization rate and clinical pregnancy rate (PR).
RESULT(S): The oocyte fertilization rate was 48.4% (534/1,104) in group 1 and 41.5% (312/751) in group 2 (not significant [NS] difference). A total of 100 cycles (97.1%) and 62 cycles (82.7%) in the obstructive and nonobstructive groups, respectively, had embryos for replacement (NS difference). The clinical PRs per ET cycle were 24% (24/100) and 17.7% (11/62) in the two groups, respectively. Oocyte fertilization rates, when fresh (46.4%) or frozen-thawed (41.8%) spermatozoa were used, were not significantly different in the two groups. The PR when fresh sperm were used was 23.6% (30/127), versus 14.3% (5/35) when frozen sperm were used (NS difference). The PR for women aged < or = 35 years was similar to that for women >35 years of age (20.7% or 29/140 and 18.2% or 4/25, respectively).
CONCLUSION(S): Epididymal and testicular sperm obtained in azoospermic patients can fertilize oocytes successfully and may lead to high fertilization rates and PRs. Freezing of these spermatozoa does not reduce the outcome of treatment significantly.
评估梗阻性或非梗阻性无精子症患者经附睾和睾丸取精后的体外受精结局。
回顾性临床分析。
公立大学附属体外受精科室。
123例无精子症患者（178个周期）。
63例梗阻性无精子症患者（103个周期）（第1组）接受附睾或睾丸取精，60例非梗阻性无精子症患者（75个周期）（第2组）接受睾丸取精并结合体外受精治疗。成熟卵母细胞采用卵胞浆内单精子注射受精。精子处理后，多余精子冷冻保存。
卵母细胞受精率和临床妊娠率（PR）。
第1组卵母细胞受精率为48.4%（534/1104），第2组为41.5%（312/751）（差异无统计学意义[NS]）。梗阻性和非梗阻性组分别有100个周期（97.1%）和62个周期（82.7%）有胚胎可供移植（差异无统计学意义）。两组每个胚胎移植周期的临床妊娠率分别为24%（24/100）和17.7%（11/62）。两组使用新鲜（46.4%）或冻融精子（41.8%）时的卵母细胞受精率无显著差异。使用新鲜精子时的妊娠率为23.6%（30/127），使用冷冻精子时为14.3%（5/35）（差异无统计学意义）。年龄≤35岁女性的妊娠率与年龄＞35岁女性相似（分别为20.7%或29/140和18.2%或4/25）。
无精子症患者经附睾和睾丸获取的精子可成功使卵母细胞受精，并可能导致较高的受精率和妊娠率。冷冻这些精子不会显著降低治疗结局。
