目的:该研究旨在评估使用不同来源(射精或非射精精子)的卵胞浆内单精子注射(ICSI)后的单胎活产(0、1、6、12和24个月)是否与出生儿童的生长发育有关。
方法:这是一项回顾性队列研究,于2016年1月至2019年12月在单个中心进行。儿童的随访数据来自江苏省母婴数据库。纳入了ICSI新鲜胚胎移植(ET)后的350例单胎活产。根据精子的起源,患者分为射精组(n=310)和非射精组(n=40).倾向评分匹配用于控制多个基线协变量,导致80个单胎活产(射精精子)与40个单胎活产(非射精)相匹配。非射精组进一步分为两个亚组:PESA组(n=23)和TESA组(n=17)。该研究的主要结果是儿童的成长和发育。次要结果包括2PN率,高卵裂胚胎率,囊胚形成率,和其他人。
结果:匹配父母年龄后,BMI,职业,和母体血清AMH水平,非射精和射精组或PESA组和TESA组之间的儿童生长发育没有显着差异,分别。然而,射精组的2PN率和囊胚形成率高于非射精组(91.02和85.45,P=0.002)和(67.37和56.06,P=0.019),分别。TESA组的优质卵裂胚胎率也高于PESA组(85.06和65.63,P=0.001)。
结论:这项研究表明,使用不同来源(射精或非射精)的ICSI后出生的儿童的生长发育没有显着差异。对于非梗阻性无精子症(OA)患者,来自睾丸的精子可能比来自附睾的精子更有效。然而,由于本研究非射精组的样本量有限,需要更大样本量的进一步调查来验证这些发现.
The
study aimed to evaluate whether singleton live births (at 0, 1, 6, 12, and 24 months) following intracytoplasmic sperm injection (ICSI) using sperm of different origins (ejaculated or non-ejaculated sperm) are associated with the growth and development of children born.
This was a retrospective cohort
study conducted at a single center from January 2016 to December 2019. Follow-up data of the children were obtained from the Jiangsu Province Maternal and Child database. A total of 350 singleton live births after fresh embryo transfer (ET) with ICSI were included. Based on the origin of the sperm, the patients were divided into two groups: the ejaculated group (n = 310) and the non-ejaculated group (n = 40). Propensity score matching was used to control for multiple baseline covariates, resulting in 80 singleton live births (ejaculated sperm) matched to 40 singleton live births (non-ejaculated). The non-ejaculated group was further divided into two subgroups: the PESA group (n = 23) and the TESA group (n = 17). The primary outcome of the
study was the growth and development of children. Secondary outcomes included the 2PN rate, high-cleavage embryo rate, blastocyst formation rate, and others.
After matching parental age, BMI, occupation, and maternal serum AMH level, there was no significant difference found in the growth and development of children between the non-ejaculated and ejaculated group or the PESA group and TESA group, respectively. However, the 2PN rate and the blastocyst formation rate were higher in the ejaculated group compared to the non-ejaculated group (91.02 and 85.45, P = 0.002) and (67.37 and 56.06, P = 0.019), respectively. The high-quality cleavage embryo rate was also higher in the TESA group compared to the PESA group (85.06 and 65.63, P = 0.001).
This study suggests that there are no significant differences in the growth and development of children born following ICSI using sperm of different origins (ejaculated or non-ejaculated). For nonobstructive azoospermia (OA) patients, sperm derived from the testis may be more effective than derived from the
epididymis. However, due to the limited sample size of the non-ejaculated group in this
study, further investigations with larger sample sizes are needed to validate these findings.