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比较微 TESE 来源的新鲜精子与冻融精子在产科和新生儿结局方面的差异。

Comparison of obstetrical and neonatal outcomes between fresh versus frozen-thawed testicular sperm derived from microTESE.

机构信息

IVF and Infertility Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

IVF and Infertility Unit, Department of Obstetrics and Gynecology, Kaplan Medical Center, affiliated with the Faculty of Medicine, Hebrew University of Jerusalem, Rehovot, Israel.

出版信息

J Assist Reprod Genet. 2024 Oct;41(10):2681-2690. doi: 10.1007/s10815-024-03265-9. Epub 2024 Sep 27.

Abstract

PURPOSE

To compare obstetrical and neonatal outcomes of embryo transfer cycles using fresh vs. frozen-thawed testicular sperm derived from microTESE in non-obstructive azoospermia (NOA) patients.

DESIGN

The retrospective cohort study included a total of 48 couples diagnosed with NOA who underwent 93 ET cycles, both fresh and frozen-thawed embryos, and resulted in pregnancy. ET cycles were divided into two groups according to sperm type, fresh (46 cycles, 49.5%) or frozen (47 cycles, 50.5%) testicular sperm. The primary outcome was the birth weight of newborns correlated with gestational week (birth weight percentile).

RESULTS

A comparison of patients' basic characteristics and ET cycle parameters showed no significant clinical differences between the groups. A total of 172 embryos were transferred, 86 (50%) in each group. A higher rate of good-quality blastocysts was found in the fresh testicular group (83.3% vs. 50%, p = 0.046). A comparison of pregnancy outcomes showed no significant differences in clinical pregnancy, implantation, or live birth rates. A total of 53 cycles resulted in live birth, 26 (49%) and 27 (51%) in the fresh and frozen groups, respectively. No difference was found in pregnancy length, delivery mode, or obstetrical complications. A total of 61 newborns were included, 31 (51%) and 30 (49%) in fresh and frozen testicular groups, respectively. No significant differences were found in mean birth weight or birth weight percentile between the groups.

CONCLUSION

No significant differences were found in obstetrical outcomes when comparing ET cycles using fresh or frozen-thawed testicular sperm retrieved from microTESE. Moreover, there is no association between the sperm source and the birth weight of newborns.

摘要

目的

比较使用新鲜和冷冻解冻睾丸精子进行胚胎移植周期在非梗阻性无精子症(NOA)患者中的产科和新生儿结局。

设计

这项回顾性队列研究共纳入了 48 对诊断为 NOA 的夫妇,他们进行了 93 个新鲜和冷冻解冻胚胎的 ET 周期,最终均妊娠。根据精子类型,将 ET 周期分为新鲜(46 个周期,49.5%)或冷冻(47 个周期,50.5%)睾丸精子组。主要结局是与孕龄相关的新生儿出生体重(出生体重百分位数)。

结果

比较患者的基本特征和 ET 周期参数,两组间无显著临床差异。共移植了 172 个胚胎,每组 86 个。新鲜睾丸组优质囊胚率较高(83.3%比 50%,p=0.046)。比较妊娠结局,临床妊娠率、种植率或活产率均无显著差异。共 53 个周期活产,新鲜组 26 个(49%),冷冻组 27 个(51%)。妊娠时间、分娩方式或产科并发症无差异。共纳入 61 名新生儿,新鲜睾丸组 31 名(51%),冷冻睾丸组 30 名(49%)。两组间平均出生体重或出生体重百分位数无显著差异。

结论

使用从 microTESE 中获得的新鲜或冷冻解冻睾丸精子进行 ET 周期,在产科结局方面无显著差异。此外,精子来源与新生儿出生体重无关。

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