ABSTRACT

Male diabetes mellitus (DM) can affect erectile function and sperm quality. In severe cases, DM can lead to retrograde or no ejaculation, so testicular sperm aspiration (TESA) is combined with intracytoplasmic sperm injection (ICSI) to treat subfertility and infertility for DM couples. However, the effect of TESA upon ICSI (TESA-ICSI) for DM patients remains unclear. This research investigated the effect of TESA-ICSI on first cycle ICSI-embryo transfer (ICSI-ET) for type 2 diabetic mellitus (T2DM) patients and the potential mechanisms. The subjects consisted of 1219 male patients with azoospermia or retrograde ejaculation who were treated with TESA-ICSI from 2015.01 to 2019.11. They were classified into two groups, the T2DM group (n = 54) and non-diabetic control group (n = 1165). Sperm selection for injection was performed using motile sperm organelle morphology examination criteria. The number of available embryos and the high-quality embryo rates following a single ET as well as cleavage, fertilization, implantation, clinical pregnancy and the abortion rates were noted. Compared with the non-diabetic group, the available embryo rate (75.20 ± 26.40% vs.78.36 ± 23.25%) and high-quality embryo rate (46.49 ± 30.37% vs. 47.55 ± 28.57%) in the T2DM group were lower and the abortion rate (20.83% vs. 8.88%) was higher, but these differences were not statistically significant. There were no significant differences in clinical pregnancy, implantation, normal fertilization, and cleavage rates between the two groups. The results show that TESA for male T2DM patients does not influence the effect of ICSI. For T2DM patients with severe oligozoospermia, asthenospermia, teratozoospermia, or retrograde ejaculation that do not meet ICSI criteria, TESA-ICSI may perhaps be considered for reproductive assistance.

Abbreviations

DM: diabetes mellitus; TESA: testicular sperm aspiration; ICSI: intracytoplasmic sperm injection; ICSI-ET; ICSI-embryo transfer; LH: luteinizing hormone; mL: milliliter; TES: testosterone; FSH: follicle-stimulating hormone; P: progesterone; HCG: human chorionic gonadotropin

中文翻译：

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睾丸精子抽吸对 2 型糖尿病男性患者第一周期 ICSI-ET 的影响。

摘要

男性糖尿病 (DM) 会影响勃起功能和精子质量。在严重的情况下，DM 会导致逆行或不射精，因此睾丸精子抽吸术 (TESA) 结合胞浆内单精子注射 (ICSI) 治疗 DM 夫妇的不育和不孕症。然而，TESA 对 DM 患者 ICSI (TESA-ICSI) 的影响仍不清楚。本研究调查了 TESA-ICSI 对 2 型糖尿病 (T2DM) 患者第一周期 ICSI 胚胎移植 (ICSI-ET) 的影响及其潜在机制。受试者包括1219名无精子症或逆行射精的男性患者，他们在2015.01至2019.11期间接受了TESA-ICSI治疗。他们被分为两组，T2DM 组（n = 54）和非糖尿病对照组（n = 1165）。使用活动精子细胞器形态学检查标准进行用于注射的精子选择。记录了单次 ET 后可用胚胎的数量和高质量胚胎率，以及卵裂、受精、着床、临床妊娠和流产率。与非糖尿病组相比，T2DM组的可用胚胎率（75.20±26.40% vs.78.36±23.25%）和优质胚胎率（46.49±30.37% vs. 47.55±28.57%）较低，流产率（20.83% vs. 8.88%）较高，但这些差异无统计学意义。两组在临床妊娠、着床、正常受精和卵裂率方面无显着差异。结果表明，TESA 对于男性 T2DM 患者不影响 ICSI 的效果。

缩写

DM：糖尿病；TESA：睾丸精子抽吸术；ICSI：胞浆内单精子注射；ICSI-ET；ICSI-胚胎移植；LH：促黄体激素；mL：毫升；TES：睾酮；FSH：促卵泡激素；P：孕酮；HCG：人绒毛膜促性腺激素