Fresh testicular sperm retrieved from men with spinal cord injury retains equal fecundity to that from men with obstructive azoospermia via intracytoplasmic sperm injection
Fresh testicular sperm retrieved from men with spinal cord injury retains equal fecundity to that from men with obstructive azoospermia via intracytoplasmic sperm injection
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DOI：
10.1016/j.fertnstert.2008.07.1776
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发表时间：
2009-10-01
影响因子：
6.7
通讯作者：
Kyono, Koichi
中科院分区：
文献类型：
--
作者：
Kanto, Satoru;Uto, Hirofumi;Kyono, Koichi
目的：探讨脊髓损伤男性睾丸精子卵胞浆内单精子注射（ICSI）的效果。设计：回顾性研究。环境：私立医院不孕不育研究实验室。患者：22对夫妇，其中一方为脊髓损伤（SCI）男性。干预措施：回顾睾丸精子提取(TESE)-ICSI的结果。主要观察指标：睾丸取精率、受精率、妊娠率、与阻塞性无精子症患者的比较。结果：22例脊髓损伤患者中有19例（86%）获得了睾丸精子。卵胞浆内单精子注射导致364例受精率为236例（65%）。在19对夫妇中，14对夫妇成功怀孕[8]，22名婴儿（14名单胎和4名双胞胎）出生。（每对夫妇的怀孕率为74%，每对ICSI为54%）。SCI夫妇和梗阻性无精子症夫妇的首次ICSI妊娠率无显著差异（SCI 68%，梗阻性无精子症68%）。然而，SCI夫妇中每新鲜精子- icsi的妊娠率显著高于每冷冻解冻精子- icsi的妊娠率（64% SCI新鲜，25% SCI冻融），尽管在阻塞性无精子症夫妇中没有显著差异（76%阻塞性无精子症新鲜，63%阻塞性无精子症冻融）。SCI夫妇新鲜ET周期与冻融ET周期的妊娠率无显著差异。结论：与梗阻性无精子症男性相比，脊髓损伤男性睾丸精子在冷冻和解冻方面可能存在劣势。新鲜睾丸精子- icsi可能为希望怀孕的SCI夫妇提供最佳结果。[j] .中国肥料学报（英文版）2009(2):1333-6。(C)2009年美国生殖医学学会。)
Objective: To examine the outcomes of intracytoplasmic sperm injection (ICSI) with testicular sperm retrieved from men with spinal cord injury.Design: Retrospective study.Setting: Private hospital-based infertility research laboratory.Patient(s): Twenty-two couples of whom one partner was a man with spinal cord injury (SCI).Intervention(s): Reviewing the outcomes of testicular sperm extraction (TESE)-ICSI.Main Outcome Measure(s): Testicular sperm retrieval rate, fertilization rate, pregnancy rate, comparison with patients with obstructive azoospermia.Result(s): Testicular sperm were retrieved from 19 of 22 (86%) patients with SCI. Intracytoplasmic sperm injection resulted in a fertilization rate of 236 of 364 (65%). Of 19 couples, 14 couples achieved][8 pregnancies, and 22 infants (14 singleton and 4 twin) were born. (Pregnancy per couple was 74% and that per ICSI was 54%). There was no significant difference in pregnancy rate at the first ICSI between SCI couples and obstructive azoospermia couples (68% SCI, 68% obstructive azoospermia). However, pregnancy rate per fresh testicular sperm-ICSI was significantly higher than that per frozen-thawed sperm-ICSI in SCI couples (64% SCI fresh, 25% SCI frozen-thawed) although no significant difference was seen in obstructive azoospermia couples (76% obstructive azoospermia fresh, 63% obstructive azoospermia frozen-thawed). There was no significant difference in pregnancy rate between fresh ET cycle and frozen-thawed ET cycle in SCI couples.Conclusion(s): Testicular sperm in men with SCI may possess disadvantages in freezing and thawing compared with that in men with obstructive azoospermia. Fresh testicular sperm-ICSI may offer optimum outcome for SCI couples desirous of pregnancy. (Fertil Steril (R) 2009-192:1333-6. (C)2009 by American Society for Reproductive Medicine.)