Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
권호 표지

Comparative Results of Embryo Development and Clinical Pregnancy using Sperm Retrieved from Fresh and Frozen-thawed Testicular Tissue from Patients with Obstructive and Non-obstructive Azoospermia

폐쇄성과 비폐쇄성 무정자증 환자에서 신선고환조직 정자와 동결고환조직 정자를 이용한 배발달률과 임신율의 비교 결과

  • Park, Yong-Seog (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Choi, Su-Jin (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Lee, Sun-Hee (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Park, Dong-Wook (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Lim, Chun-Kyu (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Jun, Jin-Hyun (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Koong, Mi-Kyoung (Department of Obstetrics and Gynecology, Kwandong University) ;
  • Park, Chan-Woo (Department of Obstetrics and Gynecology, Kwandong University) ;
  • Song, In-Ok (Department of Obstetrics and Gynecology, Kwandong University) ;
  • Seo, Ju-Tae (Department of Urology, Kwandong University)
  • 박용석 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 최수진 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 이선희 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 박동욱 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 임천규 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 전진현 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 궁미경 (관동대학교 산부인과) ;
  • 박찬우 (관동대학교 산부인과) ;
  • 송인옥 (관동대학교 산부인과) ;
  • 서주태 (관동대학교 비뇨기과)
  • Published : 2009.12.30
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Abstract

Objective: To compare the embryonic development and pregnancy results using sperms retrieved from fresh and frozen-thawed testicular tissue in patients with obstructive (OA) and non-obstructive azoospermia (NOA). Methods: A total two hundred twenty-two cycles of TESE-ICSI were performed in OA and NOA. Sperms were retrieved from fresh and frozen-thawed testicular tissue. ICSI was performed patient's own sperm. Fertilization was assessed 16~18 hrs after ICSI. Embryo development and pregnancy rates were analysed. Results: The fertilization rates were significantly different between OA and NOA patients (75.2% vs. 56.7%, p<0.05), however, embryo development did not differ between the groups (96.9% vs. 98.0%). Likewise, OA and NOA groups had no differences in their clinical pregnancy and delivery rates, 33.9% vs. 36.0% and 28.1% vs. 28.0%, respectively. With regard to sperm retrieved from fresh testicular tissue, fertilization rates were significantly different between the OA and NOA groups (76.4% vs. 52.9%, p<0.05); however, embryo development, clinical pregnancy and delivery rates were not different. For sperm retrieved from thawed testicular tissue, the fertilization rates were significantly different between the two groups (74.7% OA group vs. 65.6% NOA group, p<0.05); however, embryo development, clinical pregnancy and delivery rates were not different. Conclusions: Embryo development and clinical pregnancy did not differ in patients with obstructive and non-obstructive azoospermia, whether sperm retrieved from fresh and thawed testicular tissue were used, although the fertilization rates were different. Therefore, ICSI with sperm retrieved from fresh and thawed testicular tissue could achieve relevant clinical pregnancy results in patients with azoospermia.

목 적: 폐쇄성과 비폐쇄성 무정자증 환자에서 신선고환조직 정자와 융해고환조직 정자를 이용한 배발달과 임신결과를 비교 분석하였다. 연구방법: 폐쇄성과 비폐쇄성 무정자증 환자에서 총 222 주기의 TESE-ICSI를 시행하였다. 정자는 신선 또는 융해 고환조직으로부터 회수하였다. 수정은 ICSI 후 16~18시간째 확인하였으며, 배발달률과 임신율을 분석하였다. 결 과: 폐쇄성 무정자증군과 비폐쇄성 무정자증군에서 수정률은 유의하게 차이가 났으나 (75.2% 대 56.7%, p<0.05), 배발달률에서는 차이가 나지 않았다 (96.9% 대 98.0%). 마찬가지로 임상적 임신율 (33.9% 대 36.0%)과 분만율 (28.1% 대 28.0%)에서도 차이가 나지 않았다. 신선고환조직 정자의 경우, 수정률은 폐쇄성 무정자증군과 비폐쇄성 무정자증군에서 유의하게 차이가 났으나 (76.4% 대 52.9%, p<0.05), 배발달률, 임상적 임신율, 분만율에서는 차이가 나지 않았다. 융해고환조직 정자의 경우에서도 수정률은 폐쇄성 무정자증군과 비폐쇄성 무정자증군에서 유의하게 차이가 났으나 (74.7% 대 65.6%, p<0.05), 배발달률, 임상적 임신율, 분만율에서는 차이가 나지 않았다. 결 론: 폐쇄성과 비폐쇄성 무정자증 환자에서 신선고환조직 정자와 융해고환조직 정자를 이용하였을 경우 수정률에서는 차이가 있으나, 배발달과 임상적 임신 결과에는 차이를 보이지 않았다. 그러므로, 폐쇄성 또는 비폐쇄성 여부와는 관계없이 무정자증 환자에서 신선고환조직 정자 그리고 융해고환조직 정자를 이용하여 ICSI를 시행하면 적절한 임신 성적을 거둘 수 있다.

Keywords

References

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