The Application Of Day-Ahead Semen Collection In Patients With Semen Retrieval Difficulty And Its Effect On Pregrancy Outcome

Objective:In cycles of In vitro fertilization- embryo transfer, collecting semen difficultly will have various negative impact on the patients and lead to the cancellation of the IVF cycles. For patients of collecting semen difficultly, the current clinical response cannot avoid occuring of failure of semen collection. Based on years of clinical and laboratory practice, this paper puts forward a new approach for patients of collecting semen difficultly- day-ahead semen collection, to try to avoid testicular biopsy and oocyte cryopreservation, to reduce cycles of failure of semen collection, to decrease mental and medical expenses, to avoid cycle cancellation. This paper will explore the application of day-ahead semen collection in patients of collecting semen difficultly, to analyse the effect of day-ahead collected semen used for IVF-ET on the embryo quality and development. Methods:To gather clinical data of patients of collecting semen difficultly in our center between January 2013 and December 2015.A retrospective study was conducted to compare the percent of progressive sperm at insemination, fertilization rate, 2pn fertilization rate, 2pn cleavage rate, good quality embryo rate, blastocyst formation rate, HCG positive rate and clinical pregnancy rate between 51 IVF-ET cycles collecting day-ahead semen successfully and failing to collect semen on ovum pick-up day(research group),and 60 IVF-ET cycles collecting semen successfully on ovum pick-up day(control group). Results:there were no significant differences in Woman’s age(31.12±5.53 vs 32.18±5.13 years old), The man age(33.52±5.25 vs 34.22±5.72 years old), years of infertility(4.30±2.81 vs 5.46±3.24), antral follicle count(13.18±5.44 v 12.00±5.27) and BMI(21.95±3.05 vs 21.94±3.26 kg/m2) between the two groups(P>0.05). Dosage of Gn; days of Gn; LH, E2 and endometrial thickness on HCG day; FSH, LH and E2 on the third day(D3) for research group weren’tsignificantly different with those for control group(P >0.05). The percent of progressive sperm at insemination for research group(92.36±5.68) were slightly higher than those for control group(190.86±6.23), but there were no significant differences between the two groups(P>0.05). There were no significant differences in the number of eggs(12.72±5.40 vs 10.54±5.17), fertilization rate( 68.41%vs70.62%), 2pn fertilization rate(57.47%vs61.77%), 2pn cleavage rate(95.71%vs94.37%), good quality embryo rate(36.46%vs33.50%), blastocyst formation rate(25.74%vs28.13%), complete fertilization failure rate( 3.92%vs3.33%), HCG positive rate(58.82%vs63.33%) and clinical pregnancy rate(54.90%vs58.33%) between the two groups(P>0.05). Conclusions:1.The day-ahead collected semen can effectively be used for IVF-ET on ovum pick-up day.2.The day-ahead collected semen Will not result in an increase in complete fertilization failure rate.3.Compared with the group of collecting semen successfully on ovum pick-up day, the group of collecting day-ahead semen successfully have no significant difference in the percent of progressive sperm at insemination, fertilization rate, 2pn fertilization rate, 2pn cleavage rate, good quality embryo rate, blastocyst formation rate, HCG positive rate and clinical pregnancy rate.