Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Clinical Outcome of IVF-ET using Testicular Sperm Retrieved from Patients with Obstructive Azoospermia or Hypospermatogenesis

폐쇄성 무정자증 환자와 정자형성저하증 환자의 고환정자를 이용한 체외수정 및 배아이식술의 결과

  • Han, Sang-Chul (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • 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) ;
  • Hong, Seung-Bum (Laboratory of Reproductive Biology and Infertility, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Lee, Hyoung-Song (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) ;
  • Song, In-Ok (Department of Obsterics and Gynecology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine) ;
  • Seo, Ju-Tae (Department of Urology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine)
  • 한상철 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 박용석 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 최수진 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 이선희 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 홍승범 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 이형송 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 임천규 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실) ;
  • 송인옥 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실, 산부인과) ;
  • 서주태 (관동대학교 의과대학 제일병원 생식생물학 및 불임연구실, 비뇨기과)
  • Published : 2009.03.31
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Abstract

Objective: To compare the clinical outcomes of ICSI with sperm retrieved from testicular tissue in patients with obstructive azoospermia (OA) or hypospermatogenesis (HS). Methods: From January 2003 through December 2006, 155 patients with OA (241 cycles) and 28 patients with HS (34 cycles) were included in this study. We compared clinical outcomes of ICSI with testicular sperm such as fertilization rate, implantation rate, clinical pregnancy rate and delivery rate. Data were statistically analyzed using t-test and ${\chi}^2$-test. Results: Testicular spermatozoa could not be retrieved in 1 out of the 21 cycles where fresh testicular sperm extraction in HS patients. Fertilization rate (FR) was significantly higher in OA than HS (75.6 % vs. 62.6%, p<0.001). Cleavage rate (CR) per fertilized zygote was also significantly higher in OA than that in HS (66.8% vs. 54.8% p<0.001). However, there were no significant differences in good embryo rate (GER), clinical pregnancy rate (CPR), implantation rate (IR) and delivery rate (DR). Conclusion: Our results show that testicular sperm of HS does not affect CPR, IR, and DR although it has shown reduced FR and CR.

목 적: 폐쇄성 무정자증 (obstructive azoospermia) 환자와 정자형성저하증 (hypospermatogenesis) 환자의 고환 정자를 이용한 체외수정 및 배아이식술의 결과를 비교, 분석하고자 하였다. 연구방법: 2003년 1월부터 2006년 12월까지 체외수정 및 배아이식술을 위해 고환조직 정자채취술을 시행한 폐쇄성 무정자증 환자 155명 (241주기)과 정자형성저하증 환자 28명 (34주기)을 대상으로 하였다. 고환조직 정자채취술과 세포질내 정자주입술을 실시한 후 수정률, 착상률, 임신율, 출산율을 비교하였으며, 통계적 분석은 t-test와 ${\chi}^2$-test를 사용하였다. 결 과: 정자형성저하증 환자의 고환정자 회수 결과, 신선고환을 사용한 21주기 중 1주기에서는 정자를 회수하지 못하였으나, 정자를 확인하고 고환조직 동결보존 후 융해한 13주기에서 모두 정자를 회수할 수 있었다. 수정률은 정자형성저하증 환자보다 폐쇄성 무정자증 환자에서 통계적으로 유의하게 높았다 (75.6 % vs. 62.6%, p<0.001). 난할 배아 발생률도 정자형성저하증 환자보다 폐쇄성 무정자증 환자에서 통계적으로 유의하게 높았다 (66.8% vs. 54.8% p<0.001). 그러나 우수배아 형성률, 임상적 임신율, 착상률, 출산율에는 차이가 없었다. 결 론: 정자형성저하증 환자의 고환정자를 사용하여 세포질내 정자주입술을 실시할 경우 수정률과 초기 난할율은 폐쇄성 무정자증 환자보다 낮지만, 정상적으로 발달한 배아를 이식할 경우 임신율, 착상률, 그리고 출산율에는 영향을 미치지 않는 것으로 사료된다.

Keywords

References

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