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Les spermatozoïdes immobiles frais ou décongelés en fécondation assistée
Immobile fresh or frozen-thawed spermatozoa in assisted fertilization
Andrologie volume 9, pages 411–419 (1999)
Résumé
Contrairement au compte ou à la morphologie des spermatozoïdes, l'absence totale de mobilité du sperme peut abaisser les taux de fécondations et de grossesses en micro injection. Dans trois cas d'anomalies du squelette flagellaire (absence des bras de dynéine) l'éjaculat ne contenait que des spermatozoïdes immobiles. Après éjaculations répétées, on a pu souvent découvrir dans ces cas un taux plus élevé de spermatozoïdes viables et même quelques spermatozoïdes mobiles. Par ailleurs, dans les azoospermies sécrétoires, la recherchein extremis ne permet parfois de trouver que peu de spermatozoïdes, pour la plupart immobiles avec quelques rares spermatozoïdes mobiles, insuffisants pour tous les ovocytes. Le troisième groupe de sperme immobile en fécondation assistée, iatrogène, est consécutif à la cryoconservation de spermatozoïdes surnuméraires non éjaculés, fragments testiculaires, aspirats épididymaires, faite pour éviter des prélèvements chirurgicaux répétés. Après décongélation, on ne retrouve parfois que de rares spermatozoïdes mobiles et l'on est alors forcé d'injecter des ovocytes avec du sperme immobile. Ce travail a pour objet d'évaluer les résultats de la micro injection avec du sperme immobile dans les trois groupes susmentionnés: 1-sperme immobile avec anomalies flagellaires, 2-spermatozoïdes immobiles découverts après recherche “in extremis”, 3-sperme décongelé immobile. Les résultats de la micro injection montrent que le pouvoir fécondant en ICSI des spermatozoïdes immobiles, frais ou décongelés n'est pas très différent de celui des spermes mobiles de même origine. Plus encore, dans le groupe des anomalies flagellaires avec nécrozoospermie, des éjaculations répétées permettent d'améliorer le taux de viabilité des spermatozoïdes. La mise en évidence chez un couple d'un sperme totalement immobile, frais ou décongelé, ne devrait donc pas nous amener à renoncer à la micro injection. Des grossesses ont été ainsi obtenues avec le sperme du mari.
Abstract
Contrasting with sperm count or morphology, complete lack of mobile sperm may seriously impair ICSI fertilization and pergnancy rate. In three cases with flagellar skeleton abnormalities [dynein arm absence] only immobile sperm were found in the ejaculate. Following repeated ejaculations, higher rates of viable spermatozoa and even some motile spermatozoa could be found. Some times, in nonobstructive azoospermia, extensive sperm search didn't allow us to find but immobile sperm mostly, with very few motile sperm cells, not enough for the microinjection of all oocytes. The third group of immobile sperm is iatrogenic, following freezing and thawing surgically retrieved, testicular or epididymal spermatozoa in order to avoid repeated surgical retrieval. Following thawing, one find frequently very few motile spermatozoa that may be not enough for all retrieved oocytes and it might be necessary to inject some eggs with immobile spermatozoa. The outcome of ICSI using mobile and immobile sperm was compared in the three above mentioned groups: 1-immobile ejaculated sperm with flagellar defects, 2-immobile sperm discovered in the ejaculate after extensive sperm search and 3- immobile frozen-thawed testicular or epididymal spermatozoa. The results of ICSI in these groups show that fertilizing ability of fresh or frozenthawed immobile spermatozoa is not significantly different from ICSI with mobile sperm from the same origin. More over, in the first group with flagellar abnormalities, repeated ejaculations allowed us significantly increase sperm viability and fertilization ability. Finding only immobile fresh or frozen-thawed sperm the day of egg retrieval should not lead us to ICSI cancellation. Pregnancies may occur with such immobile sperm.
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Soffer, Y., Strassburger, D., Friedler, S. et al. Les spermatozoïdes immobiles frais ou décongelés en fécondation assistée. Androl. 9, 411–419 (1999). https://doi.org/10.1007/BF03034815
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DOI: https://doi.org/10.1007/BF03034815
Mots Clés
- Spermatozoïdes immobiles
- nécrozoospermie
- anomalies flagellaires
- azoospermies
- recherche de spermatozoïdes
- prélèvement chirurgical de spermatozoïdes
- cryo préservation
- fécondation assistée
- taux de Fécondations
- taux de grossesses