目的:优化电刺激取精术获取的精子处理和冷冻复苏方法,为临床不射精症的治疗和生育力保存提供新途径。方法:将20例同房不射精患者电刺激获取的精液(或尿液)样本分为两组,其中6例采用PBS洗涤并用Modified-HTF重悬(A组),另外14例用Modified-HTF直接洗涤并重悬(B组),对处理后精子行CASA,分析精子浓度和活动率;采用麦管载体和一步熏蒸法冷活动率为(1.12±0.41)%,M-HTF处理组的精子活动率为(9.23±9.43)%;冷冻复苏后,A组精子复苏后活动率和冷冻复苏率分别为(0.24±0.41)%、8.37%;B组的精子活动率和复苏率显著增加,分别为(4.11±2.33)%、35.41%。同样,电刺激尿液样本中,PBS处理组的精子活动率为(1.30±0.51)%,M-HTF处理组的精子活动率提高至(5.48±5.32)%;冷冻复苏后,A组的精子活动率和复苏率分别为(0.26±0.40)%、6.31%;B组的精子活动率和复苏率,分别为(3.02±1.64)%、45.88%。结论:本研究所建立的电刺激精子经体外培养及冷冻复苏的方法,可以显著增加精液和尿液样本中精子的活力,改善精子的冷冻复苏率,为临床不射精症的治疗和生育力保存提供新途径。
Objective: To improve the method for the cryopreservation of sperm collected by electroejaculation( EEJ),and find a new way for the treatment of anejaculation and preservation of fertility. Methods: Semen( or urine) samples collected by EEJ from20 male patients with anejaculation were divided into groups A( n = 6) and B( n = 14),the former washed with phosphate buffer solution( PBS) while the latter with modified HTF,both diluted in 1 ml modified HTF,followed by CASA for sperm concentration and motility. All the samples were cryopreserved for 48 hours using one-step-vaporization with the straw. Post-thaw sperm counting was conducted directly by computer-assisted semen analysis( CASA) in group A and after in vitro culture in rare sperm medium in group B.Results: In the semen samples collected by EEJ,sperm motility was( 1. 12 ± 0. 41) % in group A compared with( 9. 23 ± 9. 43) % in group B. The post-thaw sperm motility and recovery rate were( 0. 24 ± 0. 41) % and 8. 37% in the former,and significantly increased to( 4. 11 ± 2. 33) % and 35. 41% in the latter. In the urine samples,sperm motility was( 1. 30 ± 0. 51) % in group A in comparison with( 5. 48 ± 5. 32) % in group B. The post-thaw sperm motility and recovery rate were( 0. 26 ± 0. 40) % and 6. 31% in the former and remarkably increased to( 3. 02 ± 1. 64) % and 45. 88% in the latter. Conclusion: The method of sperm collection by electroejaculation and cryopreservation after in vitro culture can significantly improve sperm motility and sperm recovery rate in the semen or urine,which has provided a new strategy for the treatment of anejaculation and preservation of fertility.