Timm Odival, Cedenho Agnaldo P, Spaine Deborah M, Buttignol Marcia H P, Fraietta Renato, Ortiz Valdemar, Srougi Miguel
Laboratory of Human Reproduction, Division of Urology, Paulista School of Medicine, Federal University of São Paulo, UNIFESP, São Paulo, Brazil.
Int Braz J Urol. 2005 Jan-Feb;31(1):42-8. doi: 10.1590/s1677-55382005000100008.
To search and to identify spermatozoa and spermatids, present in the ejaculate of non-obstructive azoospermic patients.
27 patients, aged between 18 and 48 years, with initial diagnosis compatible with non-obstructive azoospermia, underwent up to 3 seminal samples, with assessment of macroscopic and microscopic parameters differentiated for each sample. In the first sample, 5 microL of semen were analyzed in a Horwell chamber in order to assess the presence or absence of spermatozoa. The procedure was repeated with 2 other aliquots. In the absence of spermatozoa, the entire sample was transferred to a conic tube and following centrifugation the sediment was freshly analyzed. The second seminal sample was collected only when no spermatozoa were found in the first sample and the research was performed in the same way. In cases where spermatozoa were not seen, the sample was centrifuged and the obtained sediment was stained by the panoptic method and observed under common light microscopy (1250X). The third seminal sample was collected only in cases when patients had not shown spermatozoa in the first and second seminal samples.
4/27 (14.8%) patients presented spermatozoa in the first seminal sample and 6/23 (26.1%), in the second seminal sample. No spermatozoa were seen in the third sample, however, 11/17 (64.7%) presented spermatids.
In clinical situations where the initial diagnosis is non-obstructive azoospermia, one single routine seminal analysis is not enough to confirm this diagnosis and the analysis of the centrifuged sediment can have relevant clinical consequences. Among patients considered non-obstructive azoospermic, when duly assessed, 37% presented spermatozoa and 64.7%, spermatids.
在非梗阻性无精子症患者的精液中寻找并鉴定精子和精细胞。
27例年龄在18至48岁之间、初步诊断符合非梗阻性无精子症的患者,接受了多达3次精液样本采集,并对每个样本的宏观和微观参数进行了区分评估。在第一个样本中,取5微升精液在霍威尔计数板中进行分析,以评估精子的有无。对另外2份等分试样重复该操作。若未发现精子,则将整个样本转移至锥形管中,离心后对沉淀物进行新鲜分析。仅在第一个样本中未发现精子时才采集第二个精液样本,并以同样的方式进行检测。若未见到精子,则将样本离心,所得沉淀物采用全视野染色法染色,并在普通光学显微镜(1250倍)下观察。仅在患者的第一和第二个精液样本中均未发现精子时才采集第三个精液样本。
4/27(14.8%)的患者在第一个精液样本中发现了精子,6/23(26.1%)的患者在第二个精液样本中发现了精子。在第三个样本中未发现精子,然而,11/17(64.7%)的患者出现了精细胞。
在初步诊断为非梗阻性无精子症的临床情况下,单次常规精液分析不足以确诊,对离心沉淀物的分析可能会产生相关临床影响。在被认为是非梗阻性无精子症的患者中,经适当评估后,37%的患者出现了精子,64.7%的患者出现了精细胞。