Hayden Russell P, Wright Diane L, Toth Thomas L, Tanrikut Cigdem
Department of Urology, Massachusetts General Hospital, Boston, MA USA.
Inception Infertility, Houston, TX USA.
Fertil Res Pract. 2016 Apr 15;2:7. doi: 10.1186/s40738-016-0020-y. eCollection 2016.
Sperm quality may degrade during transit through the male reproductive tract in some individuals. In this setting surgically retrieved testicular sperm may outperform ejaculated samples for use with in vitro fertilization (IVF) and intracytoplasmic sperm injection (IVF-ICSI). We sought to describe one center's experience with the use of fresh testicular sperm after prior failed IVF-ICSI with ejaculated samples.
A retrospective review was conducted evaluating IVF-ICSI cycles performed at a tertiary IVF unit between 2009 and 2014. Couples who were managed with percutaneous testis biopsy to obtain sperm, despite availability of ejaculated sperm, were included. Four couples who underwent a total of 6 percutaneous testis biopsy/IVF-ICSI cycles were identified. Collectively, the couples had undergone 9 prior IVF-ICSI cycles using fresh ejaculated sperm without successful pregnancy. From the six cycles that used fresh testicular sperm four live births resulted (1 twin gestation, 3 singletons). Only 1 of the 4 couples remained childless.
For patients who have had prior failed IVF-ICSI attempts, this small case series demonstrates a possible therapeutic benefit when freshly procured testicular sperm are used in lieu of ejaculated samples.
在某些个体中，精子质量在通过男性生殖道运输过程中可能会下降。在这种情况下，手术获取的睾丸精子在体外受精（IVF）和卵胞浆内单精子注射（IVF-ICSI）中可能比射出的样本表现更好。我们试图描述一个中心在先前使用射出样本进行IVF-ICSI失败后使用新鲜睾丸精子的经验。
进行了一项回顾性研究，评估2009年至2014年在一家三级体外受精单位进行的IVF-ICSI周期。纳入了那些尽管有射出精子但仍通过经皮睾丸活检获取精子进行治疗的夫妇。确定了4对夫妇，他们总共进行了6次经皮睾丸活检/IVF-ICSI周期。总体而言，这些夫妇此前使用新鲜射出精子进行了9次IVF-ICSI周期，但均未成功受孕。在使用新鲜睾丸精子的6个周期中，有4例活产（1例双胎妊娠，3例单胎）。4对夫妇中只有1对仍未生育。
对于先前IVF-ICSI尝试失败的患者，这个小病例系列表明，当使用新鲜获取的睾丸精子代替射出样本时，可能具有治疗益处。
