Hanabusa Women's Clinic, Kobe, Japan.
Andrologia. 2013 Apr;45(2):107-10. doi: 10.1111/j.1439-0272.2012.01319.x. Epub 2012 Jun 12.
An increased risk of testicular cancer in men with infertility and poor semen quality has been reported. In view of the high cure rates for testicular germ cell tumours, increasing clinical importance is being placed on the protection of fertility. High-dose cytostatic therapy may be expected to cause long-term infertility. Thus, the standard procedure for fertility protection is the cryopreservation of ejaculated spermatozoa or testicular tissue before therapy. Four male patients with azoospermia and two patients with very severe oligozoospermia underwent onco-testicular sperm extraction (TESE). We attempted onco-TESE in patients with azoospermia and very severe oligozoospermia after orchiectomy. Of the patients with testicular germ cell tumours, four had spermatozoa in their testicular tissues. Sertoli cell-only syndrome was found in one patient, and one patient showed maturation arrest without the detection of spermatozoa. Three of six showed seminomatous germ cell tumour, two of six had nonseminomatous germ cell tumour and one patient showed no malignancy. Two patients achieved clinical pregnancy. Fertility challenges in men with cancer are the most straightforward because of the relative ease of obtaining and cryopreserving sperm. Testicular sperm extraction is a useful technique for obtaining spermatozoa before cytotoxic therapy in azoospermic and very severely oligozoospermic cancer patients.
已有报道称，不孕和精液质量差的男性患睾丸癌的风险增加。鉴于睾丸生殖细胞肿瘤的高治愈率，人们越来越重视保护生育能力。高剂量细胞毒性治疗可能导致长期不孕。因此，生育保护的标准程序是在治疗前冷冻保存射出的精子或睾丸组织。四名无精子症患者和两名严重少精子症患者接受了睾丸精子提取术（TESE）。我们在睾丸切除术后继发无精子症和严重少精子症患者中尝试了睾丸精子提取术。在患有睾丸生殖细胞肿瘤的患者中，有四人的睾丸组织中有精子。一名患者被诊断为唯支持细胞综合征，一名患者表现为成熟阻滞，未检测到精子。六名患者中有三名显示精原细胞瘤，六名中有两名显示非精原细胞瘤，一名患者未显示恶性肿瘤。两名患者实现了临床妊娠。对于癌症男性来说，生育挑战是最直接的，因为获得和冷冻精子相对容易。在无精子症和严重少精子症癌症患者进行细胞毒性治疗前，睾丸精子提取术是一种获取精子的有用技术。
