Colpi Giovanni M, Colpi Elisabetta M, Piediferro Guido, Giacchetta Daniela, Gazzano Giacomo, Castiglioni Fabrizio M, Magli M Cristina, Gianaroli Luca
Andrological-Urology Unit and IVF Center, San Paolo Hospital, University of Milano, Italy.
Reprod Biomed Online. 2009 Mar;18(3):315-9. doi: 10.1016/s1472-6483(10)60087-9.
In a population of non-obstructive azoospermia patients, the efficacy of microsurgical testicular sperm extraction (microTESE) and conventional TESE was evaluated in a randomized controlled study on 138 testicles, classified and paired in a 48-square table according to the different classes of the following three variables: patient plasma FSH concentration, orchidometry and testicular histology. Sperm retrieval was positive in 21/22 testicles with hypospermatogenesis (11/11, 10/11; microTESE, TESE respectively), in 12/14 with maturation arrest (6/7, 6/7), in 16/22 with incomplete Sertoli cell-only syndrome (8/11, 8/11), and in 16/80 with complete Sertoli cell-only syndrome (11/40, 5/40). Sperm recovery was positive in 5/24 patients with FSH concentration > or = 3 x maximum value of normal range (N) (4/12, 1/12), in 17/40 patients with 2N < or = FSH < 3N (9/20, 8/20), in 30/48 patients with N < FSH < 2N (17/24, 13/24), and in 13/26 patients with FSH = N (6/13, 7/13). Regarding orchidometry, sperm recovery was positive in 11/18 testicles with volume (V) > or = 12 ml (6/9, 5/9), in 27/56 testicles with 8 ml < or = V < 12 ml (15/28, 12/28), and in 27/64 testicles with V < 8 ml (15/32, 12/32). FSH value and the surgical procedure were the two variables significantly (P < 0.05) predicting positive sperm retrieval.
在一组非梗阻性无精子症患者中，对138个睾丸进行了一项随机对照研究，评估了显微外科睾丸精子提取术（microTESE）和传统睾丸精子提取术（TESE）的疗效。根据患者血浆促卵泡激素（FSH）浓度、睾丸测量法和睾丸组织学这三个变量的不同类别，将睾丸进行分类并配对列入一个48方格表中。在21/22个生精功能低下的睾丸中精子获取呈阳性（分别为11/11、10/11；microTESE、TESE），在12/14个成熟停滞的睾丸中呈阳性（6/7、6/7），在16/22个不完全唯支持细胞综合征的睾丸中呈阳性（8/11、8/11），在16/80个完全唯支持细胞综合征的睾丸中呈阳性（11/40、5/40）。在5/24名FSH浓度≥正常范围（N）最大值的3倍的患者中精子回收呈阳性（4/12、1/12），在17/40名2N≤FSH＜3N的患者中呈阳性（9/20、8/20），在30/48名N＜FSH＜2N的患者中呈阳性（17/24、13/24），在13/26名FSH = N的患者中呈阳性（6/13、7/13）。关于睾丸测量法，在11/18个体积（V）≥12 ml的睾丸中精子回收呈阳性（6/9、5/9），在2而7/56个8 ml≤V＜12 ml的睾丸中呈阳性（15/28、12/28），在27/64个V＜8 ml的睾丸中呈阳性（15/32、12/32）。FSH值和手术方式是显著预测精子获取阳性的两个变量（P＜0.05）。
