冷冻睾丸精子对辅助生殖技术临床结局的影响  

Influence of Frozen Testicular Sperm on Clinical Outcomes of Assisted Reproductive Technology

作　　者：许小琴[1] 蔡昌明 霍骏业[1] 程立子[1] 于文娟[1] 方小武[1] XU Xiaoqin;CAI Changming;HUO Junye;CHENG Lizi;YU Wenjuan;FANG Xiaowu(Reproductive Center of Zhongshan Boai Hospital,Zhongshan 528403,China;不详)

机构地区：[1]中山市博爱医院生殖分院,广东中山528403

出　　处：《中外医学研究》2025年第10期70-75,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：中山市卫生健康局医学科研项目(2021J258)。

摘　　要：目的:探讨冷冻睾丸精子对辅助生殖技术临床结局的影响。方法:回顾性分析2019年1月—2024年4月在中山市博爱医院生殖分院使用冷冻睾丸精子进行卵胞浆内单精子注射(intracytoplasmic sperm injection,ICSI)治疗的195个周期的相关资料,根据冷冻睾丸精子质量分为有活动精子组和无活动精子组,进一步将有活动精子组和无活动精子组分为梗阻性无精症(obstructive azoospermia,OA)患者和非梗阻性无精症(non-obstructive azoospermia,NOA)患者;根据来源分为OA组和NOA组;根据冻存时间分为≤3个月组和>3个月组。比较各组基本信息与临床结局。结果:按冷冻睾丸精子质量、来源和冻存时间分组,各组女方年龄、男方年龄、不孕年限,女方体重指数(body mass index,BMI)、促卵泡激素(follicle-stimulating hormone,FSH)(基础)、黄体生成素(luteinizing hormone,LH)(基础)、雌二醇(estradiol,E2)(基础),子宫内膜厚度(移植日)、窦卵泡数、获卵总数、D3优胚率、移植胚胎数、囊胚形成率、优质囊胚率、着床率、临床妊娠率比较,差异无统计学意义(P>0.05)。有活动精子组与无活动精子组受精率比较,差异有统计学意义(P<0.05);但两组女方抗米勒管激素(anti-Müllerian hormone,AMH)(基础)比较,差异无统计学意义(P>0.05)。OA组和NOA组受精率比较,差异有统计学意义(P<0.05);但两组女方AMH(基础)比较,差异无统计学意义(P>0.05)。两组受精率比较,差异无统计学意义(P>0.05)。活动精子组OA患者受精率高于NOA患者,差异有统计学意义(P<0.001);无活动精子组OA患者受精率、囊胚形成率高于NOA患者,差异有统计学意义(P<0.01)。结论:活动精子的受精能力显著高于无活动精子,OA患者睾丸精子受精能力显著高于NOA患者,冻存时间不影响睾丸精子的受精能力;不同来源、不同质量和不同冻存时间睾丸精子不影响胚胎质量和临床妊娠率。Objective:To explore the influence of frozen testicular sperm on the clinical outcomes of assisted reproductive technology.Method:The data of 195 cycles of intracytoplasmic sperm injection(ICSI)with frozen testicular sperm in the Reproductive Center of Zhongshan Boai Hospital from January 2019 to April 2024 were retrospectively analyzed,according to the quality of frozen testicular sperm,they were divided into active sperm group and inactive sperm group,the active sperm group and inactive sperm group were further divided into obstructive azoospermia(OA)patients and non-obstructive azoospermia(NOA)patients;according to the source,they were divided into OA group and NOA group;according to the cryopreservation time,they were divided into≤3 months group and>3 months group.The basic information and clinical outcomes of each group were compared.Result:According to the quality,source and cryopreservation time of frozen testicular sperm were divided into groups,there were no significant differences in female age,male age,infertility years,female body mass index(BMI),follicle-stimulating hormone(FSH)(basal),luteinizing hormone(LH)(basal),estradiol(E2)(basal)endometrial thickness(transplantation day),number of antral follicles,total number of oocytes retrieved,D3 high-quality embryo rate,number of transplanted follicles,blastocyst formation rate,high-quality blastocyst rate,implantation rate and clinical pregnancy rate among groups(P>0.05).There was significant difference in the fertilization rate between the active sperm group and the inactive sperm group(P<0.05);however,there was no significant difference in female anti-Müllerian hormone(AMH)(basal)between two groups(P>0.05).There was significant difference in fertilization rate between OA group and NOA group(P<0.05);however,there was no significant difference in female AMH(basal)between two groups(P>0.05).There was no significant difference in fertilization rate between two groups(P>0.05).The fertilization rate of OA patients in the active sperm group was higher than

关 键 词：冷冻睾丸精子 精子质量 冻存时间 辅助生殖技术 

分 类 号：R711.6[医药卫生—妇产科学]