Hibi H, Ohori T, Yamada Y, Honda N, Asada Y
Department of Urology, Kyoritsu General Hospital, Nagoya, Japan.
Arch Androl. 2005 May-Jun;51(3):225-31. doi: 10.1080/014850190884354.
We evaluated the sperm recovery rate in non-obstructive azoospermia (NOA) patients presenting with bilateral testicular atrophy characterized by testes volume of less than 10ml and FSH levels exceeding 20 mIU/ml (group NOA-1), and compared the results to those NOA cases displaying unilateral testis volume exceeding 10 ml or FSH levels less than 20 mIU/ml (group NOA-2). Sperm retrieval was conducted in 261 azoospermic patients from April 1995 to December 2002. Forty-six NOA-1 and 37 NOA-2 individuals underwent microdissection TESE or 3-4 standard biopsies. Sperm recovery was achieved in 11 (24%) and 12 (32%) cases in NOA-1 and NOA-2, respectively. All couples received ICSI. Four clinical pregnancies (36.3%) in NOA-1 and two (17%) in NOA-2 resulted. Five subsequent healthy deliveries were obtained. NOA patients presenting with bilateral severe atrophic testes volume and obviously elevated FSH levels exhibited approximately 24% probability of sperm recovery. On the other hand, NOA characterized by testicular atrophy or elevated FSH levels displayed probability of approximately 32%. Differences in sperm recovery were not evident between NOA-1 and NOA-2. No successful pre-operative predictors of sperm recovery were identified.
我们评估了非梗阻性无精子症（NOA）患者的精子恢复率，这些患者表现为双侧睾丸萎缩，其特征为睾丸体积小于10ml且卵泡刺激素（FSH）水平超过20mIU/ml（NOA-1组），并将结果与那些单侧睾丸体积超过10ml或FSH水平低于20mIU/ml的NOA病例（NOA-2组）进行比较。1995年4月至2002年12月期间，对261例无精子症患者进行了精子提取。46例NOA-1患者和37例NOA-2患者接受了显微切割睾丸精子提取术（microdissection TESE）或3-4次标准活检。NOA-1组和NOA-2组分别有11例（24%）和12例（32%）实现了精子恢复。所有夫妇均接受了卵胞浆内单精子注射（ICSI）。NOA-1组有4例临床妊娠（36.3%），NOA-2组有2例（17%）。随后有5例健康分娩。双侧睾丸体积严重萎缩且FSH水平明显升高的NOA患者精子恢复概率约为24%。另一方面，以睾丸萎缩或FSH水平升高为特征的NOA患者精子恢复概率约为32%。NOA-1组和NOA-2组之间精子恢复的差异不明显。未发现术前预测精子恢复成功的指标。
