睾丸精子混悬液冻融的临床结局及不同冻融载体的应用效果  

Clinical outcome of freeze-thawing testicular spermatozoa suspension and application effect of different freeze-thawing carriers

作　　者：李超强 朱凯欣 冯兰青 蔡冠 吴亚敏 伍春蓉 LI Chao-qiang;ZHU Kai-xin;FENG Lan-qing;CAI Guan;WU Ya-min;WU Chun-rong(Department of Reproductive Medicine,Tung Wah Hospital of Sun Yat-Sen University,Dongguan 523110,China;Clinical Laboratory,Tung Wah Hospital of Sun Yat-Sen University,Dongguan 523110,China)

机构地区：[1]中山大学附属东华医院生殖医学科,广东省东莞市523110 [2]中山大学附属东华医院检验科,广东省东莞市523110

出　　处：《广西医学》2021年第2期146-150,共5页Guangxi Medical Journal

基　　金：广东省东莞市社会科技发展(一般)项目(2018507150461267)。

摘　　要：目的探讨睾丸精子混悬液冻融的临床结局及不同冻融载体的应用效果。方法纳入197例梗阻性无精子症患者,其中43例患者行睾丸冷冻精子卵胞浆内单精子显微注射(ICSI)治疗(冷冻组),154例行睾丸新鲜精子ICSI治疗(新鲜组)。将冷冻组的睾丸冷冻精子分为两等份,分别使用超微量冷冻麦管(麦管组)和超微量冷冻薄片(薄片组)作为载体进行冷冻,复苏后进行ICSI。比较冷冻组和新鲜组受精情况及妊娠结局,并比较两种不同冻融载体的睾丸精子的冻融效果以及胚胎结局。结果冷冻组和新鲜组的成熟卵子率、正常受精率、优质胚胎率以及种植率、周期临床妊娠率和流产率相比,差异均无统计学意义(均P>0.05)。麦管组和薄片组复苏后均能找到活动精子,并能满足卵子受精使用;麦管组和薄片组的正常受精率、卵裂率、胚胎利用率和优质胚胎率差异均无统计学意义(均P>0.05),但薄片组活动精子回收率高于麦管组(P<0.05)。结论采用睾丸冷冻精子行ICSI与睾丸新鲜精子有相似的临床结局;超微量冷冻麦管和超微量冷冻薄片做为冷冻载体的冻融睾丸精子有相似的受精率及胚胎质量,但使用超微量冷冻薄片时活动精子回收率更高。Objective To investigate the clinical outcome of freeze-thawing testicular spermatozoa suspension and the application effect of different freeze-thawing carriers.Methods Among 197 obstructive azoospermia patients enrolled,43 patients(frozen group)underwent intracytoplasmic sperm injection(ICSI)using frozen testicular spermatozoa,and 154 patients(fresh group)received ICSI using fresh testicular spermatozoa.The frozen testicular spermatozoa were equally divided into two copies frozen by using ultra-micro freeze straw(straw group)and ultra-micro freeze sheet(sheet group)as carrier respectively,and ICSI was performed after spermatozoa thawing.A comparison was conducted between the frozen group and the fresh group in terms of fertilization condition and pregnancy outcome,and also between the two different frozen carriers in terms of freeze-thawing effect of testicular spermatozoa and embryo outcome.Results There were no statistically significant differences in rate of mature egg,normal fertilization or high-quality embryo,implantation rate,clinical pregnancy rate per cycle,or abortion rate between the frozen group and the fresh group(all P>0.05).Motile sperms were found in the straw and sheet groups after thawing,and satisfying the need of ovum fertilization;no statistically significant differences were found between the straw group and the sheet group in normal fertilization rate,cleavage rate,embryo utilization rate,or high-quality embryo rate(all P>0.05),but the sheet group possessed a higher recovery rate of motile sperms as compared with the straw group(P<0.05).Conclusion ICSI using frozen testicular spermatozoa obtains a similar clinical outcome as using fresh testicular spermatozoa;the fertilization rate and embryo quality are similar between the freeze-thawing carriers,ultra-micro freeze straw and ultra-micro freeze sheet,however,application of ultra-micro freeze sheet achieves a higher recovery rate of motile sperms.

关 键 词：卵胞浆内单精子显微注射 睾丸精子 冷冻 受精效果 妊娠结局 超微量冷冻麦管 超微量冷冻薄片 胚胎结局 冻融效果 

分 类 号：R698.2[医药卫生—泌尿科学]