Ramasamy Ranjith, Lin Kathleen, Gosden Lucinda Veeck, Rosenwaks Zev, Palermo Gianpiero D, Schlegel Peter N
Center for Reproductive Medicine and Infertility, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA.
Fertil Steril. 2009 Aug;92(2):590-3. doi: 10.1016/j.fertnstert.2008.07.1703. Epub 2008 Oct 29.
To evaluate the outcomes of microdissection testicular sperm extraction (micro-TESE) in patients with high FSH.
Clinical retrospective study.
Department of urology at a tertiary university hospital.
PATIENT(S): Seven hundred ninety-two men with nonobstructive azoospermia.
INTERVENTION(S): Micro-TESE followed by intracytoplasmic sperm injection was performed. The men were classified into four groups based on serum FSH levels: <15, 15-30, 31-45, and >45 IU/mL.
MAIN OUTCOME MEASURE(S): Sperm retrieval, clinical pregnancy, and live birth rates.
RESULT(S): Testicular sperm were successfully retrieved in 60% of the men. Sperm retrieval rates in the groups of men with FSH values 15-30, 31-45, and >45 IU/mL was 60%, 67%, and 60% respectively; this was higher than the group of men with FSH < 15 (51%). Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the four groups (46%, 50%, 52%, 46% and 38%, 45%, 44%, 36%, respectively).
CONCLUSION(S): The chances of sperm retrieval using micro-TESE is just as common, if not better for men with elevated FSH levels than for men with lower FSH. Micro-TESE results appear to differ from earlier series that report low retrieval rates with random biopsies for men with elevated FSH. High FSH is not a contraindication for micro-TESE.
评估高促卵泡激素（FSH）患者行显微切割睾丸取精术（micro-TESE）的效果。
临床回顾性研究。
一所三级大学医院的泌尿外科。
792例非梗阻性无精子症男性。
行micro-TESE，随后进行卵胞浆内单精子注射。根据血清FSH水平将男性分为四组：<15、15 - 30、31 - 45和>45 IU/mL。
精子获取率、临床妊娠率和活产率。
60%的男性成功获取睾丸精子。FSH值为15 - 30、31 - 45和>45 IU/mL组的精子获取率分别为60%、67%和60%；高于FSH<15组（51%）。在获取精子的男性中，四组的临床妊娠率和活产率相似（分别为46%、50%、52%、46%和38%、45%、44%、36%）。
对于FSH水平升高的男性，使用micro-TESE获取精子的几率即便不比FSH水平较低的男性更好，至少也是一样常见的。Micro-TESE的结果似乎与早期系列研究不同，早期研究报告FSH升高的男性随机活检的获取率较低。高FSH并非micro-TESE的禁忌证。
