冻存睾丸精子用于男性生殖力储备的探讨

目的:通过研究对无精子症患者实施睾丸活检或其他手术时冷冻睾丸精子经复苏后行卵细胞胞质内单精子注射(ICSI)助孕的临床效果,探讨冻存睾丸精子作为男性生殖力储备的有效性。方法:回顾性分析了在本院实施睾丸活检或其他手术时冷冻睾丸精子的患者96例,其中的55例已在本中心复苏冷冻精子行ICSI助孕共60个周期,评估其冷冻精子复苏、卵子受精、卵裂、可移植胚胎、优质胚胎、临床妊娠及其分娩情况。结果:复苏冻存睾丸精子60个周期均获成功,复苏后行ICSI技术助孕,受精率77.6%(513/661),2PN受精率69.4%(459/661),卵裂率99.4%(510/513),可利用胚胎率84.5%(431/510),优质胚胎率40.8%(208/510);所有周期均有可移植胚胎;新鲜胚胎移植52个周期,临床妊娠30例(临床妊娠率57.7%),双胎妊娠11例(其中1例双胎自然减为单胎),单胎妊娠19例,种植率为38.7%(41/106),流产率为3.33%(1/30)。目前,已经出生了20例健康婴儿(12个男婴,8个女婴),未发现先天缺陷儿;另外13例(7例单胎和6例双胎)继续妊娠中。结论:睾丸精子冷冻复苏后行ICSI助孕可以得到较好的临床结局。冻存睾丸精子是无精子症男性生殖力储备的有效方式。

Testicular sperm cryopreservation for male fertility preservation

Objective:To investigate the effectiveness of testicular sperm cryopreservation in male fertility preservation by evaluating the clinical outcome of ICSI cycles with frozen-thawed testicular sperm for azoospermia patients.Methods:We retrospectively analyzed 96 samples of cryopreserved testicular sperm obtained by testicular biopsy,vasovasostomy(V-V),vasoepididymostomy(V-E),of which 55 were subjected to 60 ICSI cycles with frozen-thawed testicular sperm.We evaluated the rates of sperm recovery,fertilization,cleavage,transferable and good-quality embryos,clinical pregnancy,pregnancy outcome,and health of the newborns.Results:All the frozen testicular sperm samples were recovered successfully.The rates of fertilization,2PN fertilization,cleavage,available embryos and good-quality embryos were 77.6,69.4,99.4,84.5 and 40.8%,respectively.There were transferable embryos in all cycles.Fresh embryos were transferred in 52 of the 60 cycles,with the clinical pregnancy rate of 57.7%(30/52),including 19 singletons and 11 twins,and the rates of implantation and miscarriage were 38.7%(41/106) and 3.33%(1/30).Up to the present time,there have been 20 healthy newborns,including 12 boys and 8 girls,and another 13 ongoing pregnancies.No birth defects have been found so far.Conclusion:Desirable clinical outcomes can be obtained from ICSI cycles with frozen-thawed testicular sperm,and testicular sperm cryopreservation is an effective method of fertility preservation for azoospermia males.