陈碧?马天仲?宋丽君?荆霞?张云山

【摘要】 目的 探讨自身精子冷冻保存（自精保存）在辅助生殖技术中的意义。方法 ①对进行自精冻存的73例患者的临床资料进行回顾性分析， 包括精子冻存原因、冻存精子使用率、复苏成功率等。②另选同期在本中心接受自精保存作为体外受精（IVF）治疗周期患者314例（A组）， 以及夫精人工授精（AIH）术前未行任何干预患者341例（B组）， 观察两组取精困难发生率及手术取消率。结果 ①梗阻性无精子症是自精冷冻的最常见原因， 而且使用率也最高， 为57.9%；其次是严重少弱精子症及取精困难者。但取精困难及严重少弱精子症患者的冻精使用率均较低， 分别为16.7%及6.7%。精子复苏成功率均>90%， 仅2例梗阻性无精子症患者精子复苏后无足够可用精子而再次穿刺取新鲜精子。②A组患者采卵日发生取精困难者2例， 发生率0.64%， 手术取消率为0；B组患者手术日发生取精困难者8例， 发生率2.35%， 手术取消率为1.17%。结论 自身精子冷冻保存在辅助生殖技术中有重要意义， 特别是在避免梗阻性无精子症患者遭受不必要的反复侵入性操作及降低因男性取精困难造成的辅助生殖治疗周期取消率方面有重要意义。

【关键词】 精子；低温保存；辅助生殖

DOI：10.14163/j.cnki.11-5547/r.2016.08.007

Analysis of clinical effect by autologous sperm preservation in assisted reproductive technology CHEN Bi， MA Tian-zhong， SONG Li-jun， et al. Reproduction Center， Affiliated Hospital of Guangdong Medical College， Zhanjiang 524001， China

【Abstract】 Objective To investigate significance of autologous sperm cryopreservation in assisted reproductive technology. Methods ① A retrospective analysis was made on clinical data of 73 patients receiving autologous sperm cryopreservation， including their reasons for autologous sperm cryopreservation， usage rate of cryopreserved sperm， and successful recovery rate. ② There were 314 patients receiving autologous sperm cryopreservation as in-vitro fertilization （IVF） treatment （group A） and 341 patients receiving artificial insemination by husband （AIH） without any preoperative intervention （group B）. Their incidences of semen retrieval difficulty and operation cancellation rates were observed. Results ① As the most common reason in autologous sperm cryopreservation， obstructive azoospermia had the highest usage rate as 57.9%， followed by severe oligoasthenozoospermia and semen retrieval difficulty. However， the usage rates in oligoasthenozoospermia and semen retrieval difficulty were as low as 16.7% and 6.7%. The successful recovery rates in patients were all > 90%， and there were only 2 cases with obstructive azoospermia received puncture semen retrieval. ② There were 2 cases with semen retrieval difficulty in group A， with incidence as 0.64% and operation cancellation rate as 0. There were 8 cases with semen retrieval difficulty in group B， with incidence as 2.35% and operation cancellation rate as 1.17%. Conclusion Autologous sperm cryopreservation shows important significance in assisted reproductive technology， especially for avoiding unnecessary repeated invasive operation in obstructive azoospermia patients and reducing assisted reproductive technology treatment cancellation rate due to semen retrieval difficulty.

【Key words】 Sperm； Cryopreservation； Assisted reproductive technology

随着人类辅助生殖技术（assisted reproductive technology， ART）的发展， 单精子卵胞浆内注射（intracytoplasmic single sperm injection， ICSI）已渐趋成熟， 理论上只要有一条活动精子， 就能使成熟卵子受精， 使患者受孕。而精子冷冻技术日益成熟， 特别是极少量精子冷冻技术的发展， 使患者因各种因素需要冷冻自身精子用于后续ART治疗成为可能。部……