Hibi Hatsuki, Sumitomo Makoto, Fukunaga Noritaka, Sonohara Megumi, Asada Yoshimasa
Department of Urology Kyoritsu General Hospital Nagoya Japan.
Department of Urology Aichi Medical University School of Medicine Nagakute Japan.
Reprod Med Biol. 2017 Oct 31;17(1):59-63. doi: 10.1002/rmb2.12069. eCollection 2018 Jan.
To assess normal fertilization, clinical pregnancy, and live birth rates after the use of microscopic epididymal sperm aspiration (MESA).
One-hundred-and-sixty azoospermic participants who underwent MESA were evaluated. The MESA was performed by using a micropuncture method with a micropipette. In cases in which motile sperm were not obtained after the MESA, conventional or micro-testicular sperm extraction (TESE) was completed.
Adequate motile sperm were retrieved in 71 participants by using MESA and in 59 out of 89 participants by using TESE. Of the total number of patients, 123 underwent intracytoplasmic sperm injection. After MESA, the normal fertilization rate was 73.5% and the clinical pregnancy rate per case was 95.7%. Healthy deliveries resulted after MESA in 65 (92.9%) cases and after TESE in 38 (71.7%) cases.
The MESA specimen collection does not have any special requirements, such as mincing tissue disposition. The MESA also can reduce the amount of laboratory work that is needed for cryopreservation. In the authors' experience, MESA is a beneficial procedure and should be given priority over TESE.
评估显微附睾精子抽吸术（MESA）后的正常受精率、临床妊娠率和活产率。
对160例接受MESA的无精子症参与者进行评估。MESA采用微量移液器微穿刺法进行。若MESA后未获得活动精子，则完成常规或显微睾丸精子提取术（TESE）。
71例参与者通过MESA获得了足够的活动精子，89例参与者中有59例通过TESE获得了足够的活动精子。在所有患者中，123例接受了卵胞浆内单精子注射。MESA后，正常受精率为73.5%，每例临床妊娠率为95.7%。MESA后65例（92.9%）分娩健康婴儿，TESE后38例（71.7%）分娩健康婴儿。
MESA标本采集没有任何特殊要求，如组织切碎处理。MESA还可减少冷冻保存所需的实验室工作量。根据作者的经验，MESA是一种有益的手术，应优先于TESE。
