源自睾丸精子冻融胚胎卵裂球完整性及恢复卵裂对生育结局的影响.

To investigate the relationship between the blastomere integrity and reproductive outcome, the resumption of cleavage and reproductive outcome respectively, from the freeze-thawed embryo derived from testicular biopsy or testicular microsperm extraction. A retrospective analysis was performed of data from 658 patients who received frozen-thawed embryos transfer (FET). According to sperm source, these embryos were divided into 445 cycles of ejaculated sperm group (ICSI group) and 213 cycles of testicular biopsy or microdissection testicular sperm extraction (TESA group). When two embryos thawed, ICSI group was divided into three groups (A, B, C group) based on the number of integral embryos (0, 1, 2). Similarly, TESA group was also divided into D, E and F groups. ICSI group was divided into three groups (G, H, I group) according to the number of resumption of cleavages (0, 1, 2) after two embryo frozen-thawed. Similarly, TESA was also divided into J, K and L groups. The reproductive outcome were compared between the groups, respectively. ① The integrity rate, cleavage rate of embryos cultured in vitro within 18-20 h after thawing, implantation rate, clinical pregnancy rate, live birth rate, gestational age and birth weight were not significant difference between ICSI and TESA group (P>0.05). However, the early miscarriage rate in ICSI group was significantly higher than TESA group. ② There was no statistical difference in reproductive outcome mentioned above between group B and group C (P>0.05). However, the implantation rate, clinical pregnancy rate and live birth rate were significantly higher than group A (P<0.05). The reproductive outcome showed no statistical difference between three subgroups of TESA (P>0.05). There was no significant difference between ICSI and TESA groups (P>0.05). ③ The implantation rate, clinical pregnancy rate and ongoing pregnancy rate of group I were significantly higher than group H (P<0.05), and both groups were significantly higher than group G (P<0.05). The live birth rate was significantly higher in group I compared with group G and H (P<0.05). The implantation rate, clinical pregnancy rate, ongoing pregnancy rate and live birth rate of L group were significantly higher than group J (P<0.05). There was no significant difference between ICSI and TESA groups (P>0.05). Although the sperm quality of testicular biopsy or microdissection testicular sperm extraction was poor, the FET outcomes were not different from those embryos derived from ejaculated sperm once effective embryos were formed. Transferring at least one integral embryo had better reproductive outcomes than transferring two blastomere damaged embryos. Similarly, better reproductive outcomes was observed in transferring at least one cleavage embryo than two non-cleavage embryos. If there was neither integral embryo after thawing nor cleavage after overnight culture, it should be carefully considered whether to cancel the FET [ABSTRACT FROM AUTHOR]