睾丸新鲜精子与冷冻复苏精子临床妊娠结局的比较

目的 比较无精子症患者睾丸穿刺取精(testicular aspiration,TESA)与睾丸显微取精(microdissection testicular speron extraction,m-TESE)新鲜与冷冻复苏精子进行卵胞质内单精子注射(intracytoplasmic sperm injection,I...

Comparion of testicular fresh sperm and cryopreserved sperm on clinical pregnancy outcomes

Objective To compare intracytoplasmic sperm injection(ICSI) outcomes of fresh sperm and frozen-thawed sperm of azoospermia patients with testicular sperm aspiration(TESA) and microdissection testicular sperm extraction(m-TESE),and pregnancy outcomes of patients after fresh embryo and frozen-thawed embryo transplantation.Methods 1 116 cycles of ICSI assisted pregnancy were selected from June 2019 to March 2021 in the Reproductive Medicine Center of Tongji Medical College of Huazhong University of Science & Technology.Conventional superovulation and transvaginal B-mode ultrasound were used for the women to obtain mature ovum for ICSI.TESA was used in patients with obstructive azoospermia(OA) and m-TESE was used in patients with nonobstructive azoospermia(NOA).Fertilization rate, cleavage rate, good-quality embryo rate, clinical pregnancy rate, abortion rate and live birth rate of TESA fresh sperm group and TESA frozen-thawed sperm group, m-TESE fresh sperm group and m-TESE frozen-thawed sperm group were compared.And clinical pregnancy rate, abortion rate and live birth rate of OA and NOA patients after fresh embryo and frozen-thawed embryo transplantation were compared.Results In terms of fertilization rate, TESA fresh sperm group was significantly higher than TESA frozen-thawed sperm group(69.96% vs 49.33%,P<0.05),and m-TESE fresh sperm group was significantly higher than m-TESE frozen-thawed sperm group(71.86% vs 52.62%,P<0.05).In terms of good-quality embryo rate, TESA fresh sperm group was significantly higher than TESA frozen-thawed sperm group(58.93% vs 24.32%,P<0.05),and m-TESE fresh sperm group was significantly higher than m-TESE frozen-thawed sperm group(59.09% vs 49.77%,P<0.05).In terms of clinical pregnancy rate, OA transplanted with fresh embryo group was significantly higher than NOA transplanted with fresh embryo group(63.79% vs 42.86%,P<0.05).There were no significant differences in other indexes(P>0.05).Conclusion Fresh sperm can improve the success rate of fertilization and embryo quality, but has no effect on clinical pregnancy rate.OA patients transplanted with fresh embryos can achieve a higher clinical pregnancy rate than NOA patients.