不同冻贮载体在人类微量精子冷冻保存技术中的应用效果

摘要

目的:评估不同冻贮载体在人类微量精子的冷冻保存技术中的应用效果.方法:在Pubmed、ScienceDirect、SpringerLink、Willey Online Library、CNKI、维普数据库、万方数据库检索2016年12月之前发表的、有关人类微量精子冷冻保存技术的文献,筛选纳入的文献均为非随机试验性研究.根据纽卡斯尔-渥太华量表(NOS)对所纳入的研究文献进行方法学质量评估和数据提取.结果:纳入了31个研究,包含了13种不同的冻贮载体,各研究的精子回收率59%~100%,平均存活率73.7%,有9个研究将解冻精子用于卵胞浆内单精子注射(ICSI)受精,受精率18%~71%,已报道5例采用冻融微量精子ICSI受精后行胚胎移植并获得妊娠,其中3例获得健康活产婴儿.结论:目前仍没有一种较为理想的冻贮载体用于微量精子冷冻保存,还需要多中心临床试验去评估这些冻贮载体的有效性.%Objective:To assess the application of a variety of cryopreservation carriers in the cryopreservation of rare human sperm. Methods: We searched the Pubmed, ScienceDirect, SpringerLink, Willey Online Library, CNKI, VIP, WanFang databases for those relevant studies on the cryopreservation of rare human sperm up to December of 2016. The quality of the included studies was assessed according to Newcastle-Ottawa Scale (NOS). A standardized data extraction sheet was developed. Results: Identified total of 31 non-random experimental studies were identified, including 13 cryopreservation carriers used for rare human sperm. The recovery rate of sperm varied widely from 59% to 100%, and the average survival rate was 73.7%. The frozen-thawed sperm was subsequently used clinically via intracytoplasmic sperm injection (ICSI) in nine studies, and the fertilization rates were in the range of 18%~71%. Embryo transfer (ET) was performed in five studies, and 3 cases of healthy live births was reported. Conclusions: To date, there is not an ideal cryopreservationcarrier for rare human sperm in clinical practice. It is necessary to have the controlled multicenter trial to evaluate furtherly the effectiveness of those cryopreservation carriers.