V Ferracuti, A Bayram, I Elkhatib, A Abdala, E Kalafat, F Ruiz, H Fatemi, D Nogueira
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引用次数: 0
Abstract
Purpose: To evaluate differences in post-insemination events between fresh and frozen-derived gametes when testicular sperm extraction (TESE) is used.
Method: A retrospective cohort study including 980 oocytes retrieved across 72 cycles from 30 couples, between January 2017 and September 2023. Gamete sources were fresh (fresh-TESE) or frozen-thawed-TESE (frozen-TESE) from the same patients with non-obstructive azoospermia (NOA), and fresh or vitrified (frozen) oocytes from the same female partner. Following insemination by TESE-sperm, embryos were cultured in a time-lapse (TL) incubator. Resulting blastocysts underwent trophectoderm (TE) biopsy for preimplantation genetic testing for aneuploidy (PGT-A) by next-generation sequencing (NGS). Fertilization, usable blastocysts, and euploidy rates were recorded, and morphokinetic key parameters were annotated.
Results: Oocyte/sperm dyads using frozen-TESE showed an association with lower fertilization (OR 0.64, 95% CI 0.45-0.89, P = 0.008) and lower blastulation/MII (OR 0.53, 95% CI 0.37-0.77, P = 0.001), but similar blastulation/2PN (OR 0.69, 95% CI 0.45-1.07, P = 0.09). After accounting for female age, euploidy per tested blastocyst was similar whether fresh or frozen-TESE was used, but frozen oocyte use showed no association with these outcomes. The use of frozen dyads was associated with longer duration of 2PN after tPNa to tPNf: in frozen-TESE, 2.10 h longer (95% CI 0.55-3.64, P = 0.008) and in vitrified oocytes, 2.34 h longer (95% CI 0.31-4.36, P = 0.024). Slight morphokinetic differences between fresh and frozen-TESE were observed during subsequent developmental stages.
Conclusions: Synchronizing fresh-TESE with oocyte retrieval, when possible, appears safer to maximize fertilization rates. Regardless of the gamete type, frozen-sourced sperm or oocyte impact 2PN-lag time, possibly indicating nuclear repair mechanisms post-freezing, requiring further investigation.
目的：评价使用睾丸精子提取（TESE）时新鲜配子和冷冻配子授精后事件的差异。方法：回顾性队列研究，包括2017年1月至2023年9月期间从30对夫妇中采集的72个周期的980个卵母细胞。配子来源为来自同一名非阻塞性无精子症（NOA）患者的新鲜（fresh- tese）或冻融tese (frozen- tese)，以及来自同一名女性伴侣的新鲜或玻璃化（冷冻）卵母细胞。用tese精子授精后，胚胎在延时（TL）培养箱中培养。通过下一代测序（NGS），对胚泡进行滋养外胚层（TE）活检，进行着床前非整倍体（PGT-A）基因检测。记录受精率、可用囊胚率和整倍体率，并对形态动力学关键参数进行注释。结果：使用冷冻tese的卵母细胞/精子双体与较低的受精率（OR 0.64, 95% CI 0.45-0.89, P = 0.008）和较低的囊胚/产出率（OR 0.53, 95% CI 0.37-0.77, P = 0.001）相关，但与囊胚/产出率相似（OR 0.69, 95% CI 0.45-1.07, P = 0.09）。在考虑了女性年龄后，无论使用新鲜的还是冷冻的tese，每个被测试的囊胚的整倍性都是相似的，但冷冻卵母细胞的使用与这些结果没有关联。冷冻卵母细胞的使用与tPNa到tPNf后2PN持续时间的延长有关：冷冻的tese延长2.10小时（95% CI 0.55-3.64, P = 0.008），玻璃化的卵母细胞延长2.34小时（95% CI 0.31-4.36, P = 0.024）。在随后的发育阶段，观察到新鲜和冷冻tese之间存在轻微的形态动力学差异。结论：在可能的情况下，将新鲜tese与卵母细胞回收同步，似乎更安全，可以最大限度地提高受精率。无论配子类型如何，冷冻来源的精子或卵母细胞影响2pn滞后时间，可能表明冷冻后的核修复机制，需要进一步研究。
期刊介绍：
The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species.
The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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