研究開発・学会発表

【発表の概要】

OBJECTIVE: The development of ICSI opened a new era in the field of
assisted reproduction and revolutionized the assisted reproductive treatment (ART) protocols of couples with male factor infertility. Fertilization and pregnancies can be obtained with spermatozoa recovered from the seminiferous tubules. We hereby report fertility for men with obstructive (OA) and non-obstructive azoospermia (NOA) patients following treatment by frozen and thawed testicular spermatozoa (cryoTESE)-ICSI and evaluate the factors other than spermatozoa.

DESIGN: Retrospective clinical analysis.

MATERIALS AND METHODS: Seventy-four men with OA and 140 men
with NOA undergoing attempted cryoTESE-ICSI. Seventy-three couples
with OA underwent a total of 184 cryoTESE-ICSI and 46 couples with
NOA underwent a total of 75 cryoTESE-ICSI treatment cycles. The causes
of NOA included Sertoli cell-only, maturation arrest, post-chemotherapy
azoospermia, cryptorchidism and post-mumps testicular atrophy. The number of eggs at MII injected, 2 pronuclei (PN) oocytes, normal cleaved embryos, embryos transferred, transfers cycles, biochemical pregnancies,
clinical pregnancies, implantation rate, and delivered were examined.

RESULTS: Fertilization rate in NOA was significantly less common than
in OA. In both OA and NOA patients, no significant difference of the cryopreserved period was shown between clinical pregnancy positive and negative groups. Neither the pathology, the source, nor the quantity of
spermatozoa had any effect on fertilization or pregnancy rates. Maternal age had no effect on fertilization or embryo cleavage, but did dramatically affect the implantation, pregnancy and delivery rates both.

CONCLUSIONS: Good pregnancy rates were achieved without significant
differences among the sperm sources. The pregnancy and the delivery rate
were dependent strictly on the age of the wife but not on her ovarian reserve.