Effects of different sperm extraction methods on clinical pregnancy and perinatal outcome
10.3760/cma.j.cn101441-20210710-00304
- VernacularTitle:不同取精方式行ICSI对临床妊娠及围产结局的影响
- Author:
Yang LIU
1
;
Lu YANG
1
;
Yunxia WANG
1
;
Yiwen XIONG
1
;
Bingnan REN
1
;
Jijun HU
1
;
Xianfeng YANG
1
;
Yichun GUAN
1
;
Lijun SUN
1
Author Information
1. 郑州大学第三附属医院生殖医学科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Sperm injection, intracytoplasmic;
Sperm retrieval method;
Pregnancy outcome;
Perinatal outcome
- From:
Chinese Journal of Reproduction and Contraception
2022;42(10):1058-1064
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of different sperm retrieval methods on clinical pregnancy and perinatal outcomes in patients undergoing intracytoplasmic sperm injection (ICSI) for pregnancy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent ICSI for male factors in Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from October 2015 to October 2020. A total of 3096 cycles were included. Patients with oligozoospermia had sperm retrieval by ejaculation, which was recorded as ejaculation group ( n=2558); patients with azoospermia had sperm retrieval by surgical method (PESA/TESA/mirco-TESE), which was recorded as surgical sperm retrieval group ( n=538). The ovulation promotion and embryo culture of the two groups were compared and analyzed, and the clinical pregnancy outcome and perinatal outcome indexes of fresh embryo transfer patients in the two groups were observed. Results:Data from both groups were adjusted for confounding factors by linear/logistic regression, which revealed that the number of high-quality embryos [ MD(95% CI)=0.412(0.153-0.670), P=0.002] and blastocyst formation [ MD(95% CI)=0.265(0.035-0.494), P=0.024] were significantly higher in surgical sperm retrieval group relative to ejaculation group, and the number of two pronuclei (2PN) and the number of available embryos were not statistically different (all P>0.05). The embryo implantation rate [a OR(95% CI)=1.311(1.010-1.701), P=0.042] and the clinical pregnancy rate [a OR(95% CI)=1.307(1.007-1.697), P=0.044] were significantly higher in patients after fresh embryo transfer. The differences in live birth rate, multiple birth rate, miscarriage rate, singleton preterm birth rate, singleton full-term neonatal weight and sex ratio between the two groups were not statistically significant (all P>0.05). Conclusion:Patients with azoospermia can still obtain a live birth rate comparable to that of conventional ICSI through surgical sperm retrieval and do not increase the risk of miscarriage, fetal malformation, singleton preterm birth, or full-term low birth weight babies.
