McVicar C M, O'Neill D A, McClure N, Clements B, McCullough S, Lewis S E M
Obstetrics and Gynaecology, School of Medicine, Queen's University Belfast, Institute of Clinical Science, UK.
Hum Reprod. 2005 Oct;20(10):2795-800. doi: 10.1093/humrep/dei138. Epub 2005 Jun 15.
Each year 40,000 men have a vasectomy in the UK whilst another 2400 request a reversal to begin a second family. Sperm can now be obtained by testicular biopsy and subsequently used in assisted conception with ICSI. The study aims were to compare sperm yields of men post-vasectomy or with obstructive azoospermia (OA) of unknown aetiology with yields of fertile men and to assess any alteration in the clinical pregnancy rates after ICSI.
Testicular tissue was obtained by Trucut needle from men who had undergone a vasectomy >5 years previously or had OA from other causes and from fertile men during vasectomy. Seminiferous tubules were milked to measure sperm yields. Numbers of Sertoli cells and spermatids and thickness of the seminiferous tubule walls were assessed using quantitative computerized analysis.
Sperm yields/g testis were significantly decreased in men post-vasectomy and in men with OA, relative to fertile men. Significant reductions were also observed in early (40%) and mature (29%) spermatid numbers and an increase of 31% was seen in the seminiferous tubule wall (basal membrane and collagen thickness) of vasectomized men compared with fertile men. Clinical pregnancy rates in couples who had had a vasectomy were also significantly reduced.
在英国，每年有40000名男性接受输精管切除术，另有2400人要求进行输精管复通术以组建第二个家庭。现在可以通过睾丸活检获取精子，随后用于卵胞浆内单精子注射（ICSI）辅助受孕。本研究的目的是比较输精管切除术后男性或病因不明的梗阻性无精子症（OA）患者与生育期男性的精子产量，并评估ICSI后临床妊娠率的任何变化。
通过Trucut针从输精管切除术后超过5年的男性、因其他原因患有OA的男性以及输精管切除术中的生育期男性获取睾丸组织。挤压生精小管以测量精子产量。使用定量计算机分析评估支持细胞和精子细胞的数量以及生精小管壁的厚度。
相对于生育期男性，输精管切除术后男性和OA患者每克睾丸的精子产量显著降低。输精管切除术后男性的早期（40%）和成熟（29%）精子细胞数量也显著减少，与生育期男性相比，输精管切除术后男性的生精小管壁（基底膜和胶原厚度）增加了31%。输精管切除术后夫妇的临床妊娠率也显著降低。
