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从受伤战士中抽吸精囊精子。

Seminal vesicle sperm aspiration from wounded warriors.

机构信息

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland; Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.

出版信息

Fertil Steril. 2016 Sep 1;106(3):579-83. doi: 10.1016/j.fertnstert.2016.05.028. Epub 2016 Jun 21.

Abstract

OBJECTIVE

To assess whether seminal vesicle sperm aspiration (SVSA) is an option for wounded warriors with severe genital and testicular injuries, with the goal of cryopreservation to use in future assisted reproductive technology (ART) cycles.

DESIGN

Retrospective case series.

SETTING

Tertiary care military hospital.

PATIENT(S): Six wounded warriors.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Seminal vesicle fluid analysis after harvest, after thaw analysis, fertilization rates, pregnancy rates (PRs), live birth.

RESULT(S): Six patients with lower extremity, pelvic, and genital injuries from dismounted improvised explosive devices underwent SVSA within 5-12 days of the initial injury. Sperm retrieved were analyzed (volume, 0.4-1.8 mL; concentration, 40-2,200 K; motility, 0-5%), washed, and cryopreserved. Two patients underwent IVF/intracytoplasmic sperm injection (ICSI) cycles using their samples. In one couple, fertilization rate was 38%. One grade V embryo was transferred with a negative pregnancy test. The second couple underwent two cycles. In their first cycle, fertilization rate was 44%, with one blastocyst transferred and a negative pregnancy test. In the second cycle, fertilization rate was 47%. Two blastocysts were cryopreserved due to ovarian hyperstimulation syndrome (OHSS) concerns. One blastocyst was later transferred in a frozen cycle resulting in a live birth.

CONCLUSION(S): The SVSA is a reasonable option to retrieve sperm in wounded warriors or trauma patients with extensive genital injuries.

摘要

目的

评估精囊抽吸术(SVSA)是否适用于严重生殖器和睾丸损伤的战士,以冷冻保存精子,用于未来的辅助生殖技术(ART)周期。

设计

回顾性病例系列。

地点

三级护理军事医院。

患者

六名战士。

干预措施

无。

主要观察指标

收获后、解冻后分析的精囊液分析、受精率、妊娠率(PR)、活产率。

结果

六名下肢、骨盆和生殖器受伤的患者因简易爆炸装置而受伤,在初次受伤后 5-12 天内接受了 SVSA。对获得的精子进行了分析(体积 0.4-1.8ml;浓度 40-2200K;活力 0-5%),进行了洗涤和冷冻保存。两名患者使用他们的样本进行了体外受精/胞浆内精子注射(ICSI)周期。在一对夫妇中,受精率为 38%。一枚 V 级胚胎移植,妊娠试验阴性。第二对夫妇进行了两个周期。在他们的第一个周期中,受精率为 44%,一个胚胎移植,妊娠试验阴性。在第二个周期中,受精率为 47%。由于卵巢过度刺激综合征(OHSS)的担忧,冷冻保存了两个胚胎。一个囊胚后来在冷冻周期中转移,导致活产。

结论

SVSA 是一种合理的选择,可以在生殖器广泛损伤的创伤患者或战士中获取精子。

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