A Paired Case-control Study of Assisted Reproduction and Assisted Pregnancy Outcomes in Patients with Extreme Asthenospermia,Azoospermia and Normal Semen
Objective To investigate the outcome of assisted reproduction in patients with extreme asthenos-permia,azoospermia and normal semen by the paired case-control study.Methods A retrospective case-matching study was conducted,patients who received assisted reproductive technology in the Reproductive Medicine Center,General Hospital of Ningxia Medical University from May 2014 to December 2022 were selected for the first time to enter the cycle of fresh transplantation.According to the preoperative semen examination of the male partner,215 patients with severe oligospermia and asthenospermia were screened as the severe oligospermia and asthenospermia group,and 134 patients with azoospermia undergoing surgical sperm retrieval were screened as the azoospermia surgical sperm retrieval group.Based on the age,BMI,ovarian reserve function,and ovulation stimulation status of both partners in the severe oligospermia and asthenospermia group and the azoospermia surgical sperm retrieval group,in the patients with azoospermia(134 cases),according to the age,BMI,ovarian reserve function,ovulation promotion and other parameters of the couple,the couple who entered the cycle for the first time,and the fresh transplant cycle with normal semen analysis parameters were selected in the same period.In this study,430 cases and 268 cases were selected as the control group through 1∶2 matching,respectively.The general conditions,number of eggs obtained,MII egg rate,normal fertilization rate,normal rupture rate,good embryo rate,blastocyst formation rate,implantation rate,clinical pregnancy rate,live birth rate,single birth rate,twin birth rate,single premature birth rate,abortion rate,ectopic pregnancy rate and gender ratio were compared between the extreme asthenospermia group and the normal parameter group,the azoospermia group(epididymis and testicular extraction)and the normal semen parameter group,respectively.Results The average age,BMI,antral follicle number(AFC),female basal hormone level,AMH,total amount and days of Gn use,endometrium thickness and E2 level on HCG day were no significant difference(P all＞0.05).The infertility years of the two study groups were longer than that of the control group,and the difference was statistically significant(P all＜0.05).In the laboratory results of the two study groups,the MII egg rate was similar,the normal fertilization rate,normal cleavage rate and high-quality embryo rate were higher than the control group,there were statistical differences(P all＜0.05),and the blastocyst culture formation rate was lower than the control group.The implantation rate,clinical pregnancy rate and live birth rate of the two groups were higher than that of the control group,and the clinical pregnancy rate of the azoospermia group was higher than that of the control group and the difference was statistically significant(P all＜0.05),The other results of single birth rate,twin birth rate,premature birth rate of single birth,abortion rate,ectopic pregnancy rate and male to female sex ratio were not statistically different(P all＞0.05).Conclusion In the first fresh embryo transfer cycle,the number and motility of sperm and the source of semen in the routine analysis of male semen parameters do not affect the clinical pregnancy outcome of assisted reproduction.
万方数据
维普
