Grynberg M, Chevalier N, Mesner A, Rocher L, Prisant N, Madoux S, Feyereisen E, Ferlicot S, Fanchin R, Frydman R, Frydman N, Izard V
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92141 Clamart, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 Apr;40(2):130-6. doi: 10.1016/j.jgyn.2010.11.003. Epub 2010 Dec 22.
Analyzing the results and validating the procedure of testicular sperm extraction (TESE) performed on the day of oocyte retrieval in non obstructive azoospermia (NOA) patients.
Sixty TESE were performed on the day of oocyte retrieval (dOR), in 52 NOA men. Patients were sorted into three groups according to the results of the surgical procedure: 1: sperm recovery with possible sperm freezing (n=20); 2: sperm recovery without freezing (n=27); 3: "negative" biopsy (n=13). ICSI outcomes in the two groups with sperm recovery were compared to those of ICSI performed with frozen-thawed sperm obtained from TESE performed (n=13).
The rate of positive sperm retrieval was 78%. While the overall clinical pregnancy rate was 50%, no difference in the fertilization, implantation and clinical pregnancy rates was found in the two groups with positive sperm retrieval as compared to frozen-thawed sperm group. Twelve pregnancies were obtained in patients without further sperm cryopreservation.
After TESE in NOA men, cryopreserved sperm produced comparable results with freshly obtained sperm. However, TESE performed on dOR can offer the opportunity, in patients with rare sperm that might not survive freeze-thaw, to have a possible fresh embryo transfer. Couples should be counselled regarding the possibility of oocyte retrieval without sperm for ICSI.
分析非梗阻性无精子症（NOA）患者在取卵日进行睾丸精子提取（TESE）的结果并验证该操作程序。
对52例NOA男性在取卵日（dOR）进行了60次TESE。根据手术结果将患者分为三组：1：精子回收且可能进行精子冷冻（n = 20）；2：精子回收但未冷冻（n = 27）；3：“阴性”活检（n = 13）。将两组有精子回收的患者的卵胞浆内单精子注射（ICSI）结果与使用从之前进行的TESE获得的冻融精子进行ICSI的结果（n = 13）进行比较。
精子回收阳性率为78%。总体临床妊娠率为50%，与冻融精子组相比，两组精子回收阳性的患者在受精、着床和临床妊娠率方面未发现差异。未进行进一步精子冷冻保存的患者获得了12次妊娠。
NOA男性进行TESE后，冻存精子与新鲜获得的精子产生的结果相当。然而，在取卵日进行TESE可为精子稀少可能无法耐受冻融的患者提供进行新鲜胚胎移植的机会。应向夫妇咨询取卵时未获得用于ICSI的精子的可能性。
