Schroeder-Printzen I, Zumbé J, Bispink L, Palm S, Schneider U, Engelmann U, Weidner W
Department of Urology, University of Giessen, Germany.
Hum Reprod. 2000 Dec;15(12):2531-5. doi: 10.1093/humrep/15.12.2531.
Microsurgical epididymal sperm aspiration (MESA) combined with intracytoplasmic sperm injection (ICSI) represents a great advance in the therapy of non-reconstructable obstructive azoospermia. For procedure synchronization, a great number of organizational facilities are needed. Intentional cryopreservation of the aspirate may reduce these problems, therefore the aim of this study was to analyse the amount and quality of aspirate fluid obtained by means of MESA and the quality of the vials after thawing. Furthermore, the available cryopreserved straws were calculated. A total of 93 consecutive MESA procedures were performed and epididymal spermatozoa were obtained in 88 patients. Mean sperm concentration was 40.9 x 10(6) spermatozoa/ml. Global and progressive motility were 24.8 and 7.5% respectively. In one-third of the aspirates, no progressive motile spermatozoa were found. The mean number of straws available was 7.6. In 33 ICSI cycles with frozen-thawed epididymal spermatozoa, a pregnancy rate of 42.4% was achieved. In conclusion, these data show that enough spermatozoa are available for various ICSI cycles following a single MESA procedure in men with non-reconstructable obstructive azoospermia. Furthermore, ICSI with cryopreserved spermatozoa leads to excellent pregnancy rates
显微外科附睾精子抽吸术（MESA）联合卵胞浆内单精子注射（ICSI）在不可重建性梗阻性无精子症的治疗方面取得了巨大进展。为了使手术同步进行，需要大量的组织设施。对抽吸物进行有意冷冻保存可能会减少这些问题，因此本研究的目的是分析通过MESA获得的抽吸液的量和质量以及解冻后小瓶的质量。此外，还计算了可用的冷冻保存细管数量。共进行了93例连续的MESA手术，88例患者获得了附睾精子。平均精子浓度为40.9×10⁶个精子/毫升。总体活力和前向运动活力分别为24.8%和7.5%。在三分之一的抽吸物中未发现前向运动的精子。可用细管的平均数量为7.6根。在33个使用冷冻解冻附睾精子的ICSI周期中，妊娠率达到了42.4%。总之，这些数据表明，对于患有不可重建性梗阻性无精子症的男性，单次MESA手术后有足够的精子用于各种ICSI周期。此外，使用冷冻保存精子的ICSI可导致极高的妊娠率。
