All enrolled male patients underwent short-interval secondary ejaculation on the day of oocyte retrieval, and 786 sibling MII oocytes from 67 cycles were equally divided into two groups based on whether the injected spermatozoons originated from the first or second ejaculation. Semen parameters, embryo development efficiency, morphokinetic parameters and clinical outcomes were compared between the two groups to assess the efficiency and clinical value of short-interval second ejaculation in ICSI cycles.
Short-interval second ejaculation significantly improved sperm motility, normal morphological rate, and sperm DNA integrity both before and after sperm swim-up. The high-quality blastocyst rate (24.79% versus 14.67%), available blastocyst rate (57.56% versus 48.44%), and oocyte utilization rate (52.93% versus 45.29%) were significantly higher in the second ejaculation group (P<0.05). The clinical pregnancy rate (59.09% versus 47.37%), implantation rate (42.11% versus 32.35%) and live birth rate (40.91% versus 31.58%) were higher in the second ejaculation group, but the differences were not significant (P>0.05). Time-lapse analysis showed that morphokinetic time points after the 7-cell stage were earlier in the second ejaculation group but without a significant difference (P>0.05), and abnormal embryo cleavage patterns between the two groups were not significantly different (P>0.05).
Short-interval second ejaculation significantly improves sperm quality in oligoasthenozoospermic males, and is beneficial for blastocyst formation efficiency in ICSI cycles. This study suggested a non-invasive and simple but effective strategy for improving ICSI treatment outcomes.
■所有入选的男性患者在取卵当天接受了短期二次射精,根据注射的精子是来自第一次射精还是第二次射精,将来自67个周期的786个同胞MII卵母细胞平均分为两组。精液参数,胚胎发育效率,比较两组的形态动力学参数和临床结局,以评估ICSI周期短间隔二次射精的效率和临床价值.
■短间隔二次射精显著提高精子活力,正常形态率,精子游泳前后的精子DNA完整性。高质量囊胚率(24.79%对14.67%),可用囊胚率(57.56%对48.44%),第二次射精组的卵母细胞利用率(52.93%对45.29%)显着升高(P<0.05)。临床妊娠率(59.09%对47.37%),第二次射精组的着床率(42.11%对32.35%)和活产率(40.91%对31.58%)较高,但差异不显著(P>0.05)。延时分析显示,第二次射精组7细胞期后形态动力学时间点更早,但差异无统计学意义(P>0.05)。异常胚胎卵裂模式两组间差异无统计学意义(P>0.05)。
■短间隔第二次射精可显著提高少弱精子症男性的精子质量,并且有利于ICSI周期中胚泡形成效率。这项研究提出了一种非侵入性和简单但有效的策略来改善ICSI治疗结果。