Tese ile sperm elde edilerek ICSI uygulanmış azospermik hastaların kriptozoospermik olanlarla fertilizasyon ve gebelik oranlarının karşılaştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
T.C. Maltepe Üniversitesi, Lisansüstü Eğitim Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnfertilite, çiftlerin en az bir yıl süre içerisinde hiçbir korunma yöntemi olmaksızın cinsel ilişkiye rağmen kadında gebeliğin oluşmaması durumudur. Gebelik elde edemeyen çiftlerin yarıya yakın kısmında erkek faktörü bulunmaktadır. Son derece düşük sperm sayısı ve sperm motilitesi olan kriptozoospermik ya da azospermik erkeklerde üremeye yardımcı tekniklerin kullanılmasını ICSI gerektirir. Bu çalışmada azospermi sebebiyle Testiküler Sperm Ekstraksiyonu (TESE) yapılan intrasitoplazmik sperm enjeksiyonu (ICSI) uygulanmış hastalar ile kriptozoospermik hastalar için fertilizasyon ve gebelik oranlarının retrospektif karşılaştırılması amaçlandı. Çalışma kriterlerine uyan 528 (1.grup azospermik n=256 ve 2.grup kriptozoospermik n=272) hasta çalışmanın örneklemini oluşturdu. Gruplarda %48,5’lik oranla (n=256) azospermi olgusu ve %51,5’lik oranla (n=272) kriptozoospermi olgusu bulunmaktadır. Olguların % 100’ünde (n=528) döllenme olduğu görüldü. Araştırmaya katılan 528 olgudan 92 tanesinde çeşitli sebeplerden dolayı embriyo transferi yapılamadığı, 436 olguda embriyo transferi yapıldığı görüldü. ET yapılan 436 olgudan %44,3’ünde (n=193) gebelik görülmezken, %55,7’sinde (n=243) gebelik görüldü. Kriptozoospermi grubundaki olgularda freezing yapılma oranı, azospermi grubundakilerden istatistiksel olarak anlamlı seviyede yüksek saptandı (p=0,008; p<0,01). Kriptozoospermi grubundaki olgularda 2PN sayısı ?6 olanların oranı, azopermi grubundakilerden istatistiksel olarak anlamlı seviyede yüksek saptandı (p=0,036; p<0,05). Azospermik grupta gebelik oranı %51 ve kriptozoospermik grupta %49 (p<0.059) olup, iki grup arasında istatistiksel olarak anlamlı fark bulunmamıştır. Sonuç olarak gebelik oranlarında farklılık saptanmazken, kriptozoospermik vakalarda ise fertilizasyonun ve embriyo transferinden sonra kalan dondurulacak embriyo sayılarının daha yüksek olduğu gözlendi. Bu değerlendirmeden hareketle kriptozoospermik vakalarda TESE uygulamanın ejekülat spermine tercih edilmesinin fertilizasyon ve dondurulacak embriyo sayılarını arttırsa da transfer ve gebelik oranını arttırmayacağı yargısına varıldı.
Infertility is the inability of couples to achieve pregnancy despite unprotected sexual intercourse for at least one year. The male factor is present in almost half of the couples who cannot achieve pregnancy. The use of assisted reproductive techniques in men with extremely low sperm count and sperm motility, such as cryptozoospermia or azoospermia, requires ICSI. The aim of this study was to retrospectively compare fertilization and pregnancy rates for patients who underwent Testicular Sperm Extraction (TESE) due to azoospermia and those with cryptozoospermia who underwent intracytoplasmic sperm injection (ICSI). 528 patients (256 with azoospermia and 272 with cryptozoospermia) who met the study criteria were included in the study. Azoospermia was present in 48.5% (n=256) of the patients in the first group, while cryptozoospermia was present in 51.5% (n=272) of the patients in the second group. Fertilization was observed in 100% of the cases (n=528). Embryo transfer could not be performed in 92 of the 528 cases due to various reasons, while embryo transfer was performed in 436 cases. Pregnancy was observed in 55.7% (n=243) of the cases with embryo transfer, while it was not observed in 44.3% (n=193). The freezing rate was significantly higher in the cryptozoospermia group than in the azoospermia group (p=0.006; p<0/01). The rate of cases with 2PN count ?6 in the cryptozoospermia group was significantly higher than that in the azoospermia group (p=0.036; p<0/05). The pregnancy rate was 51% in the azoospermic group and 49% in the cryptozoospermic group (p<0.059), and there was no significant difference between the two groups. In conclusion, there was no difference in pregnancy rates, but it was observed that the number of embryos to be frozen after fertilization and embryo transfer was higher in cryptozoospermia group. Based on this evaluation, it was concluded that applying TESE in cryptozoospermia cases instead of ejaculate sperm would increase fertilization and the number of frozen embryos, but it would not increase the transfer and pregnancy rates.
Infertility is the inability of couples to achieve pregnancy despite unprotected sexual intercourse for at least one year. The male factor is present in almost half of the couples who cannot achieve pregnancy. The use of assisted reproductive techniques in men with extremely low sperm count and sperm motility, such as cryptozoospermia or azoospermia, requires ICSI. The aim of this study was to retrospectively compare fertilization and pregnancy rates for patients who underwent Testicular Sperm Extraction (TESE) due to azoospermia and those with cryptozoospermia who underwent intracytoplasmic sperm injection (ICSI). 528 patients (256 with azoospermia and 272 with cryptozoospermia) who met the study criteria were included in the study. Azoospermia was present in 48.5% (n=256) of the patients in the first group, while cryptozoospermia was present in 51.5% (n=272) of the patients in the second group. Fertilization was observed in 100% of the cases (n=528). Embryo transfer could not be performed in 92 of the 528 cases due to various reasons, while embryo transfer was performed in 436 cases. Pregnancy was observed in 55.7% (n=243) of the cases with embryo transfer, while it was not observed in 44.3% (n=193). The freezing rate was significantly higher in the cryptozoospermia group than in the azoospermia group (p=0.006; p<0/01). The rate of cases with 2PN count ?6 in the cryptozoospermia group was significantly higher than that in the azoospermia group (p=0.036; p<0/05). The pregnancy rate was 51% in the azoospermic group and 49% in the cryptozoospermic group (p<0.059), and there was no significant difference between the two groups. In conclusion, there was no difference in pregnancy rates, but it was observed that the number of embryos to be frozen after fertilization and embryo transfer was higher in cryptozoospermia group. Based on this evaluation, it was concluded that applying TESE in cryptozoospermia cases instead of ejaculate sperm would increase fertilization and the number of frozen embryos, but it would not increase the transfer and pregnancy rates.
Açıklama
Anahtar Kelimeler
Azospermi, TESE, Kriptozoospermi, ICSI, Fertilizasyon, İnsan, Gebelik, Azoospermia, TESE, Cryptozoospermia, ICSI, Fertilization, Human, Pregnancy
Kaynak
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Scopus Q Değeri
Cilt
Sayı
Künye
Mammadli, L. (2023). Tese ile sperm elde edilerek ICSI uygulanmış azospermik hastaların kriptozoospermik olanlarla fertilizasyon ve gebelik oranlarının karşılaştırılması / Comparison of fertilization and pregnancy rates between azoospermia patients whose sperm were obtained by tese and cryptozoosperm in ICSI cycles. (Yayımlanmamış Yüksek Lisans Tezi). Maltepe Üniversitesi, Lisansüstü Eğitim Enstitüsü, İstanbul.
