Seda Karabulut, Oya Korkmaz, Yusuf Sağıroğlu, İlknur Keskin

Dondurulmuş Ejekülat ve Dondurulmuş Testiküler Spermin Sonuçlarının İntrasitoplazmik Sperm Enjeksiyonu (ICSI) Parametrelerine Etkisinin Değerlendirilmesi

Amaç: Çalışmamızda, dondurulmuş ejekülat ve dondurulmuş testiküler spermin İntrasitoplazmik Sperm Enjeksiyonu (ICSI) sonuçları üzerine etkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Çalışmamızda 11.10.2016- 12.09.2017 tarihleri arasında infertilite nedeniyle ICSI tedavisine alınan ve spermleri dondurulan 36 çift çalışmaya alınmıştır. Hastaların 14 tanesine ejekülat sperm kriyoprezervasyonu, 22 tanesine de micro testiküler sperm ekstraksiyonu (TESE) sperm kriyoprezervasyonu gerçekleştirilmiştir. İki grubun ICSI sonuçları (fertilizasyon oranı, embriyo gelişme oranı ve gebelik oranları) karşılaştırılmıştır.Bulgular: Sperm parametreleri değerlendirildiğinde ejekülat ve TESE spermlerinde dondurma öncesi ve dondurma sonrası toplam motilite ve canlılık oranları arasında istatistiksel bir fark belirlenmemiştir (>0.05). Fertilizasyon oranları, implantasyon oranları ve embriyo gelişme oranları arasında ist tistiksel olarak anlamlı bir fark gözlemlenmemiştir (>0.05). Gebelik oranları ise dondurulmuş ejekülat grubunda dondurulmuş testiküler sperm grubuna oranla istatistiksel olarak anlamlı derecede yüksek bulunmuştur (<0.05).Sonuç: Sperm kriyoprezervasyonun uzun yıllardır ICSI tedavilerinde kullanılmasına rağmen yöntemin etkinliği üzerine araştırmalar devam etmektedir. Çalışmamızın bulguları doğrultusunda spermin ICSI sürecini olumsuz ekilememesine rağmen gebelik oranlarında anlamlı düşüşe neden olduğu sonucuna varılmıştır. Bunun, implantasyon sürecinde spermin oynadığı rol nedeniyle olabileceği düşünülmektedir. Bu etkinin ortaya koyulabilmesi ve implantasyon sürecinde görev alan mekanizmaların aydınlatılabilmesi için, daha büyük hasta gruplarıyla yapılmış moleküler seviyede çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler:

Kriyopreservasyon, Sperm, TESE, ICSI

Evaluation of the Effect of Frozen Ejaculate and FrozenTesticular Sperm Results on Inrtacytoplasmic Sperm Injection (ICSI) Parameters

Objective:The aim of the present study is to investigate the effect of frozen ejaculate and frozen testicular sperm on ICSI results.Materials and Methods: 36 infertile couples that underwent an ICSI cycle and that the semen samples were frozen between 11.10.2016-12.09.2017 in were included in the study. Ejaculate sperm cryopreservation was performed in 14 patients and micro TESE sperm cryopreservation was performed in 22 patients.ICSI results (fertilization rate, embryo development rate and pregnancy rates) of the two groups were compared.Results: There were no statistically significant difference between total motility and viability rates before and after freezing in ejaculate and testicular sperm extraction (TESE) sperm (> 0.05). When ICSI parameteres were compared nostatistically significant difference were observed between fertilization rates, implantation rates and embryo development rates (> 0.05). But pregnancy rates were found statistically significantly higher in frozen ejaculate group than frozen testicular sperm group (<0.05).Conclusion: Although sperm cryopreservation has been used in ICSI treatments for many years, re- search and debate on the effectiveness of the method continues. According to our results frozen testicular sperm had no adverse effect on ICSI parameteres but we analyzed a significant decrease in pregnancy rates. This may be partially explained by the role of sperm in the implantation process. In order to demonstrate this effect and to elucidate the mechanisms involved in the implantation process, molecular studies with larger patient groups are needed.

Keywords:

cryopreservation, Sperm, TESE, ICSI,

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