en اثر محیط Cult-active بر نتایج بارداری پس از تزریق داخل سیتوپلاسمی اسپرم در مردان آزواسپرمی: یک مطالعه مورد شاهدی Reproductive Andrology Original Article Original Article <div style="text-align: justify;"><strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">فعال&shy;سازی ناموفق تخمک به دنبال تزرق داخل سیتوپلاسمی اسپرم (</span></span><span dir="LTR"><span style="font-size:10.0pt;">ICSI</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) در نتیجه کمبود کلسیم یک چالش بزرگ است.</span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">هدف: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">ما تأثیر محیط کشت فعال&shy;کننده تخمک (</span></span><span dir="LTR"><span style="font-size:10.0pt;">CAM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) را بر نتایج </span></span><span dir="LTR"><span style="font-size:10.0pt;">ICSI</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در موارد آزواسپرمی انسدادی مقایسه کردیم.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مواد و روش &shy;ها: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">مطالعه حاضر با 152 مورد </span></span><span dir="LTR"><span style="font-size:10.0pt;">ICSI</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در دو گروه فعال&shy;سازی تخمک مصنوعی (</span></span><span dir="LTR"><span style="font-size:10.0pt;">CAM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) و کنترل انجام شد. تخمک&shy;های تزریق شده در گروه کنترل در محیط کلیواژ کشت شدند، در حالی که در گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">CAM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">، تخمک&shy;ها از طریق قرار گرفتن در معرض 200 میکرولیتر </span></span><span dir="LTR"><span style="font-size:10.0pt;">CAM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">به مدت 15 دقیقه به صورت شیمیایی فعال شدند. نرخ لقاح و کلیواژ، کیفیت جنین و میزان حاملگی بیوشیمیایی و تولد زنده در هر دو گروه مورد بررسی قرار گرفت.</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">میزان لقاح و کلیواژ پس از استفاده از </span></span><span dir="LTR"><span style="font-size:10.0pt;">CAM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">در زیرگروه آسپیراسیون اسپرم از اپیدیدیم (001/0 </span></span><span style="font-size:10.0pt;">&ge; </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">، 05/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) (</span></span><span dir="LTR"><span style="font-size:10.0pt;">PESA</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) و در زیرگروه استخراج اسپرم از بیضه (</span></span><span dir="LTR"><span style="font-size:10.0pt;">TESE</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">) در مقایسه با گروه&shy;های کنترل خود تفاوت معنی‌داری وجود داشت (04/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">، 02/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">). همچنین میزان بارداری در زیرگروه&nbsp; &nbsp;</span></span><span dir="LTR"><span style="font-size:10.0pt;">PESA-CAM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> به طور معنی‌داری بیشتر بود (03/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">). زیرگروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">PESA-CAM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> تفاوت معنی داری را در کیفیت جنین پس از </span></span><span dir="LTR"><span style="font-size:10.0pt;">ICSI</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نشان داد (04/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">). انتقال ناموفق جنین و سقط جنین در هر دو زیرگروه نسبت به گروه کنترل خود کمتر بود، اما این تفاوت معنی&shy;دار نبود. به طور معنی&shy;دار، نرخ تولد زنده در زیر گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">PESA-CAM</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;"> بالاتر بود (03/0 </span></span><span style="font-size:10.0pt;">= </span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">).</span></span><br> <strong><span style="font-family:B Mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری:</span></span></strong> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">تیمار با </span></span><span dir="LTR"><span style="font-size:10.0pt;">CAM</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">می‌تواند میزان لقاح و کلیواژ را در موارد آزواسپرمی انسدادی بهبود بخشد. تأثیر معنی&shy;داری بر کیفیت جنین و میزان حاملگی و تولد زنده در موارد </span></span><span dir="LTR"><span style="font-size:10.0pt;">PESA</span></span> <span style="font-family:B Mitra;"><span style="font-size:11.0pt;">وجود داشت.</span></span><strong><span dir="LTR"><span style="font-family:Arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong></div> <div style="text-align: justify;"><strong>Background:</strong> Failed oocyte activation following intracytoplasmic sperm injection (ICSI) as a result of calcium deficiency is a major challenge.<br> <strong>Objective:</strong> We compared the effect of cult-active medium (CAM) on ICSI outcomes in obstructive azoospermia cases.<br> <strong>Materials and Methods:</strong> The present study was conducted with 152 ICSI cases, classified into CAM and control groups. The injected oocytes in the control group were cultured in the cleavage medium, while in the artificial oocyte activation group, oocytes were chemically activated through exposure to 200 &micro;L of CAM for 15 min. Fertilization and cleavage rates, quality of embryos, and biochemical pregnancy and live birth rates were assessed in both groups.<br> <strong>Results:</strong> There were significant differences between the groups in terms of fertilization and cleavage rates after using the CAM in the percutaneous epididymal sperm aspiration (PESA) subgroup (p = 0.05, p &le; 0.001) and in the testicular sperm extraction subgroup (p = 0.02, p = 0.04), compared to their control groups. Also, the pregnancy rate was significantly higher in the PESA-CAM subgroup (p = 0.03). The PESA-CAM subgroup demonstrated a significant difference in embryo quality after ICSI (p = 0.04). Unsuccessful embryo transfer and abortion were lower in both subgroups compared to the control groups, but this difference was not significant. Surprisingly, live birth rate was higher in the PESA-CAM subgroup (p = 0.03).<br> <strong>Conclusion:</strong> CAM treatment could improve fertilization and cleavage rates in obstructive azoospermia participants. It had a significant effect on embryo quality, and pregnancy and live birth rates in PESA cases.</div> یونوفور کلسیم, آزواسپرمی انسدادی, لقاح, ICSI. Calcium ionophore, Obstructive azoospermia, Fertilization, ICSI. 1059 1066 http://ijrm.ir/browse.php?a_code=A-10-1289-1&slc_lang=en&sid=1 Elham Asa asa.elham@gmail.com 0000-0003-2549-5719 Yes Department of Reproductive Biology, Academic Center for Education, Culture, and Research (ACECR), Qom, Iran. Rahil Janatifar Rahiljanati2016@gmail.com 0000-0002-6913-4010 No Department of Reproductive Biology, Academic Center for Education, Culture, and Research (ACECR), Qom, Iran. Seyedeh Saeideh Sahraei sahraei.saeideh@gmail.com 0000-0002-4943-5748 No Department of Reproductive Biology, Academic Center for Education, Culture, and Research (ACECR), Qom, Iran. Atefeh Verdi atefeh.verdi@yahoo.com 0000-0001-9474-0058 No Department of Reproductive Biology, Academic Center for Education, Culture, and Research (ACECR), Qom, Iran. Naser Kalhor naserkalhor@gmail.com 0000-0001-8870-8035 No Department of Mesenchymal Stem Cells, Academic Center for Education, Culture, and Research (ACECR), Qom, Iran.