睾丸精子冷冻复苏对辅助生殖妊娠结局及新生儿安全性的影响  

The impact of testicular frozen-thawed sperm on pregnancy outcomes and newborn safety of ART

作　　者：方庭枫[1] 区颂邦[1] 廖早文 欧阳能勇[1] FANG Ting-feng;OU Song-bang;LIAO Zao-wen;OUYANG Neng-yong(Department of Obstetrics&Gynecology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University/Guangdong Provincial Clinical Research Center for Obstetrical&Gynecological Diseases,Guangzhou 510120)

机构地区：[1]中山大学孙逸仙纪念医院妇产科,广东省妇产疾病临床医学研究中心,广州510120

出　　处：《生殖医学杂志》2025年第2期157-163,共7页Journal of Reproductive Medicine

摘　　要：目的比较睾丸新鲜精子与冷冻复苏精子对辅助生殖助孕结局的影响。方法回顾性分析2019年1月至2023年6月于中山大学孙逸仙纪念医院生殖医学中心行睾丸穿刺取精(TESA)后卵胞浆内单精子注射(ICSI)助孕治疗的无精子症患者及其配偶的临床及实验室资料,共340个TESA-ICSI周期。根据精子类型将患者分为新鲜精子组(n=221)和冷冻精子组(n=119)。比较两组患者的胚胎发育、妊娠及新生儿结局;应用单因素及多因素Logistic回归分析活产率的影响因素。结果新鲜精子组的原发不孕比例显著低于冷冻精子组(70.14%vs.79.83%,P<0.05),两组间其余一般资料比较均无显著性差异(P>0.05)。两组间胚胎发育情况比较,双原核(2PN)受精率、2PN卵裂率、可利用胚胎数、囊胚形成率、优质胚胎率比较均无显著性差异(P>0.05)。两组间植入率、临床妊娠率、异位妊娠率、自然流产率、活产率、早产率比较均无显著差异(P>0.05),新鲜精子组周期取消率显著低于冷冻精子组(38.01%vs.49.58%,P<0.05)。两组共活产96例新生儿,两组间新生儿分娩孕周、单胎出生体重、新生儿畸形率比较均无显著差异(P>0.05);新鲜精子组双胎出生体重显著低于冷冻精子组[(2.28±0.38)kg vs.(2.79±0.31)kg](P<0.05)。在校正了女方年龄、女方体质量指数(BMI)、男方年龄、男方BMI后,多因素Logistic回归分析结果显示,睾丸精子冷冻复苏对活产率并无显著影响(校正OR=0.77,P=0.442)。结论睾丸精子冷冻复苏不明显影响辅助生殖的胚胎发育、妊娠结局及新生儿安全性。Objective:To compare the effects of testicular fresh sperm and frozen-thawed sperm on the outcomes of ART.Methods:Azoospermia patients who underwent ICSI after testicular sperm aspiration(TESA)at the Reproductive Medicine Center of Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University from January 2019 to June 2023 were recruited,and a retrospective analysis of clinical and laboratory data of 340 TESA-ICSI cycles in these azoospermia patients and their spouses were conducted.Patients were divided into two groups according to the type of sperm as fresh sperm group(n=221)and frozen sperm group(n=119).The differences in embryo development,pregnancy outcomes,and neonatal outcomes between the two groups were compared,univariate and multivariate logistic regression analyses were conducted to identify factors influencing the live birth rate.Results:The proportion of primary infertility in the fresh sperm group was significantly lower than that in the frozen sperm group(70.14%vs.79.83%,P<0.05),while there were no significant differences in other basic data between the two groups(P>0.05).There were no significant differences in two pronuclei(2PN)fertilization rate,2PN cleavage rate,the number of available embryos,blastocyst formation rate,and high-quality embryo rate between the two groups in terms of embryo development(P>0.05).There were no significant differences in the implantation rate,clinical pregnancy rate,ectopic pregnancy rate,spontaneous abortion rate,live birth rate,and preterm birth rate between the two groups(P>0.05).The cycle cancellation rate in the fresh sperm group was significantly lower than that in the frozen sperm group(38.01%vs.49.58%,P<0.05).There were a total of 96 live births between the two groups,and there were no significant differences in gestational age at delivery,singleton birth weight,and neonatal malformation rate between the two groups(P>0.05).The birth weight of twins in the fresh sperm group was significantly lower than that in the frozen sperm group[(2.28±0.38)kg vs.(2.79±0.31)kg,P<0

关 键 词：睾丸穿刺取精 睾丸精子冷冻 无精子症 卵胞浆内单精子注射 新生儿结局 

分 类 号：R711.6[医药卫生—妇产科学]