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梗阻性无精子症和射精功能障碍患者进行睾丸穿刺抽吸及睾丸组织冷冻保存后的结局

Outcomes after testicular aspiration and testicular tissue cryopreservation for obstructive azoospermia and ejaculatory dysfunction.

作者信息

Garg Tullika, LaRosa Cean, Strawn Estil, Robb Paul, Sandlow Jay I

机构信息

Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

出版信息

J Urol. 2008 Dec;180(6):2577-80. doi: 10.1016/j.juro.2008.08.034. Epub 2008 Oct 31.

Abstract

PURPOSE

We examined the rate of successful sperm retrieval, fertilization, pregnancy and live births in patients with obstructive azoospermia and ejaculatory dysfunction who underwent testicular sperm aspiration in conjunction with in vitro fertilization/intracytoplasmic sperm injection using cryopreserved testicular tissue.

MATERIALS AND METHODS

We retrospectively reviewed the records of 40 couples who underwent testicular sperm aspiration from August 2003 to November 2007. All procedures were performed before intracytoplasmic sperm injection with the goal of tissue cryopreservation.

RESULTS

Mature sperm was successfully retrieved and cryopreserved in 39 of 40 patients (97%) with an average of 5 vials cryopreserved per couple. Of the women 34 underwent in vitro fertilization/intracytoplasmic sperm injection and in 5 treatment was planned. The fertilization rate was 58% with a pregnancy rate of 61.4% (27 of 44 cycles). There were 17 live births, 5 ongoing pregnancies and 5 miscarriages. No complications were noted and all patients returned to full activity within 2 to 3 days.

CONCLUSIONS

Testicular sperm aspiration with cryopreservation is a safe and effective sperm retrieval method in patients with obstructive azoospermia and ejaculatory dysfunction when in vitro fertilization/intracytoplasmic sperm injection will be performed.

摘要

目的

我们研究了梗阻性无精子症和射精功能障碍患者在接受睾丸精子抽吸术并结合使用冷冻保存的睾丸组织进行体外受精/卵胞浆内单精子注射时,成功获取精子、受精、妊娠及活产的比率。

材料与方法

我们回顾性分析了2003年8月至2007年11月期间40对接受睾丸精子抽吸术夫妇的记录。所有操作均在卵胞浆内单精子注射前进行,目的是保存组织。

结果

40例患者中有39例(97%)成功获取并冷冻保存了成熟精子,每对夫妇平均冷冻保存5瓶。34名女性接受了体外受精/卵胞浆内单精子注射,5名女性计划进行治疗。受精率为58%,妊娠率为61.4%(44个周期中有27例)。有17例活产、5例持续妊娠和5例流产。未观察到并发症,所有患者在2至3天内恢复正常活动。

结论

对于将进行体外受精/卵胞浆内单精子注射的梗阻性无精子症和射精功能障碍患者,睾丸精子抽吸术联合冷冻保存是一种安全有效的精子获取方法。

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