Bladou F, Grillo J M, Rossi D, Noizet A, Gamerre M, Erny R, Luciani J M, Serment G
Service d'Urologie, Hôtel Dieu, Marseille, France.
Hum Reprod. 1991 Oct;6(9):1284-7. doi: 10.1093/oxfordjournals.humrep.a137527.
Epididymal sperm aspiration is a new treatment for vasal agenesis. In previous reports, epididymal spermatozoa resulted in pregnancy by utilizing in-vitro fertilization (IVF) or gamete intra-Fallopian transfer (GIFT). We sought to investigate the efficacy of epididymal sperm aspiration in conjunction with IVF in patients with congenital absence of the vas deferens or with secondary extended obstruction of spermatic ducts. Fifty-eight attempts were performed in 23 patients (25-50 years). Eight patients (34.7%) had vasal agenesis and 14 (60.8%) presented with vasal secondary extended obstruction. The sperm count was adequate (greater than or equal 20 x 10(6)/ml) in 13.8% of sperm retrievals and sperm motility of 20% was obtained in 15.5% of sperm retrievals. Fourteen attempts at IVF were performed with epididymal sperm counts of 2-44 x 10(6)/ml and motilities of 0-45%. A mean of six mature oocytes (0-13) were inseminated in each case. Five embryo transfers were performed in five patients' wives (35.7%) and two couples had an early pregnancy loss (14.2%). Epididymal sperm aspiration is an advance in treating such patients, as an adequate number of mature spermatozoa can be obtained and used for IVF. However, spermatozoa directly aspirated from the proximal epididymis and with fertilizing capacity in vitro, gave a high rate of embryo degeneration (greater than 50%) after embryo transfer.
附睾精子抽吸术是治疗输精管缺如的一种新方法。在以往的报道中，附睾精子通过体外受精（IVF）或配子输卵管内移植（GIFT）实现了妊娠。我们旨在研究附睾精子抽吸术联合IVF治疗先天性输精管缺如或继发性输精管广泛梗阻患者的疗效。对23例患者（25 - 50岁）进行了58次尝试。8例患者（34.7%）患有输精管缺如，14例（60.8%）表现为输精管继发性广泛梗阻。13.8%的精子采集样本精子计数充足（大于或等于20×10⁶/ml），15.5%的精子采集样本精子活力达到20%。对附睾精子计数为2 - 44×10⁶/ml且活力为0 - 45%的患者进行了14次IVF尝试。每例平均有6个成熟卵母细胞（0 - 13个）受精。对5例患者的妻子进行了5次胚胎移植（35.7%），2对夫妇出现早期妊娠丢失（14.2%）。附睾精子抽吸术是治疗此类患者的一项进展，因为可以获得足够数量的成熟精子并用于IVF。然而，直接从附睾近端抽吸的具有体外受精能力的精子，在胚胎移植后胚胎退化率较高（大于50%）。
