Houwen Juul, Lundin Kersti, Söderlund Brita, Bergh Christina, Kremer Jan A M, Ekerhovd Erling
Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, the Netherlands.
Acta Obstet Gynecol Scand. 2008;87(10):1033-8. doi: 10.1080/00016340802356891.
To assess the efficacy of the two most common sperm retrieval procedures, testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) as part of the diagnostic work-up in men with non-obstructive azoospermia. Design. Retrospective cohort study.
Center for Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Three hundred fifty men who underwent diagnostic surgical sperm recovery between January 1997 and December 2006.
A diagnostic TESA was initially performed in 281 men with testes of >12 mm(3). If no spermatozoa or an insufficient number of spermatozoa was found, most of the men underwent a diagnostic TESE. Diagnostic TESE was performed as the only surgical procedure in 69 men who had at least one testis < or =12 mm(3).
Success rates of diagnostic TESA and diagnostic TESE.
Spermatozoa were found in 129 (45.9%) of the 281 men who underwent TESA. However, in 29 of these men too few spermatozoa were identified for the men to be accepted for IVF/ICSI. The subsequent TESE resulted in 26 additional men being accepted for IVF/ICSI. In men with testes < or =12 mm(3) a sufficient number of spermatozoa were found in 27 out of 69 men following TESE.
The study shows that in 52% of the men with non-obstructive azoospermia spermatozoa useful for ICSI can be identified. For at least one-third of the men with testes >12 mm(3) TESA is a sufficient procedure. Sperm retrieval rate is further increased following a subsequent TESE.
评估两种最常见的取精程序，即睾丸精子抽吸术（TESA）和睾丸精子提取术（TESE），作为非梗阻性无精子症男性诊断检查一部分的疗效。设计：回顾性队列研究。
瑞典哥德堡萨尔格伦斯卡大学医院生殖医学中心。
1997年1月至2006年12月期间接受诊断性手术取精的350名男性。
最初对281名睾丸体积大于12立方毫米的男性进行诊断性TESA。如果未发现精子或精子数量不足，大多数男性接受诊断性TESE。对69名至少有一个睾丸体积小于或等于12立方毫米的男性，仅进行诊断性TESE作为手术程序。
诊断性TESA和诊断性TESE的成功率。
在接受TESA的281名男性中，129名（45.9%）发现了精子。然而，其中29名男性的精子数量太少，无法接受体外受精/卵胞浆内单精子注射（IVF/ICSI）。随后的TESE使另外26名男性能够接受IVF/ICSI。在睾丸体积小于或等于12立方毫米的男性中，TESE后69名男性中有27名发现了足够数量的精子。
该研究表明，在52%的非梗阻性无精子症男性中，可以识别出对ICSI有用的精子。对于至少三分之一睾丸体积大于12立方毫米的男性，TESA是一种足够的程序。随后进行TESE可进一步提高取精率。
