稀少精子冻融后行卵胞浆内单精子注射对受精结局的影响

目的 探讨TESA 获得的稀少精子冻融后行ICSI 的受精结局。方法 回顾性分析本中心2014 年1 月至2021 年4 月对因严重少、弱、畸形精子症患者射出的精子行常规ICSI，对非梗阻性无精子患者经过TESA 得到的少量新鲜或冻融后精子行ICSI，共200 例患者为研究对象。按精子来源不同分为A：常规ICSI 精子组（n=107）；B：冷冻TESA 精子组（n=35）；C：新鲜TESA 精子组（n=58）。通过病例对照研究，分析比较各组临床一般资料和实验室数据，评估胚胎质量。结果 B组获卵数、卵子成熟率（11.63±2.87）枚，82.31%]与A 组（10.81±3.21）枚，82.63%]和C 组（11.46±3.16）枚，82.41%]相比，差异无统计学意义（P＞0.05）。B 组的正常受精率、正常卵裂率、优质胚胎率（62.99%、84.83%、34.64%）与A 组（82.11%、97.07%、48.29%）和C 组（73.18%、91.02%、42.47%）相比，差异有统计学意义（P＜0.05）。结论 经皮睾丸精子抽吸术获得的稀少精子冷冻复苏后行卵胞浆内单精子注射能够解决非梗阻性无精子症患者的不育难题。

The effect of intracytoplasmic sperm injection after freezing and thawing of rare sperm on the outcome of fertilization

Objective To investigate the fertilization outcome of intracytoplasmic sperm injection(ICSI) after freezing and thawing of rare sperm obtained by testicular puncture (TESA) in patients with non-obstructive azoospermia.Methods A total of 200 patients,including the patients with severe oligozoospermia,asthenozoospermia,and teratozoospermia who underwent conventional ICSI on ejaculated sperm and the patients with non-obstructive azoospermia ICSI who underwent ICSI on a small amount of fresh or frozen-thawed sperm obtained by TESA from January 2014 to April 2021 in our center were retrospectively analyzed.They were divided into group A (conventional ICSI sperm group,107 cases),group B (frozen TESA sperm group,35 cases),group C (fresh TESA sperm group,58 cases) according to different sperm sources.Through case-control studies,the general clinical data and laboratory data of each group were analyzed and compared.The embryo quality was evaluated.Results There was no significant difference in the number of egg retrieved and egg maturation rate between group B (11.63±2.87),82.31%] and group A (10.81±3.21,82.63%) and group C (11.46±3.16,82.41%)(P>0.05).The normal fertilization rate,normal cleavage rate and high-quality embryo rate of group B (62.99%,84.83%,34.64%) were significantly different from those of group A (82.11%,97.07%,48.29%) and group C (73.18%,91.02%,42.47%) (P<0.05).Conclusion Intracytoplasmic sperm injection after cryopreservation of rare sperm obtained by testicular sperm aspiration can solve the infertility problem in patients with non-obstructive azoospermia.