Inoue Taketo, Sugimoto Hironobu, Okubo Kazutoshi, Emi Nobuyuki, Matsushita Yukiko, Kojima Kenji, Nakamura Mitsuaki, Ono Yoshiyuki
Ono Ladies Clinic 538-3 Nishihonmachi 675-1375 Ono Hyogo Japan.
Department of Biophysics, Graduate School of Health Sciences Kobe University 10-2, Tomogaoka 7-chome, Suma-ku 654-0142 Kobe Japan.
Reprod Med Biol. 2010 May 18;9(3):173-177. doi: 10.1007/s12522-010-0053-6. eCollection 2010 Sep.
This case report describes two successful pregnancies after intracytoplasmic sperm injection (ICSI) with testicular spermatozoa that were transported under refrigeration.
Two first-time couples consulted our clinic concerned about their primary infertility. No sperm were present in the semen samples from either of the husbands and they were referred to the urology department (UD) of a neighbouring hospital. At the UD, seminiferous tubules were obtained by testicular sperm extraction. The tissue samples were put in a centrifuge tube with phosphate-buffered saline at 6°C and placed with refrigerant in a cushioned styrofoam box that was then transported to our clinic. Immediately upon arrival at our clinic, testicular spermatozoa were extracted. On the same day, ovum pickup was performed and mature oocytes were extracted that were then inseminated by conventional ICSI. Fertilized eggs were cultured for 2 days, and then cleaved embryos were cryopreserved. In one case after 4 months and in the other case after 2 months of cryopreservation, the frozen-thawed embryos were transferred.
Both patients became pregnant and normal, healthy babies were born.
These results suggest that cases of obstructive azoospermia can be treated with ICSI by refrigerated transport of the seminiferous tubules, in cooperation with a UD, in a small single departmental obstetrics and gynecology clinic.
本病例报告描述了两例通过胞浆内单精子注射(ICSI)使用经冷藏运输的睾丸精子成功妊娠的案例。
两对初婚夫妇因原发性不孕前来我院咨询。两位丈夫的精液样本中均未发现精子,他们被转诊至附近医院的泌尿外科(UD)。在泌尿外科,通过睾丸精子提取获取曲细精管。将组织样本置于装有6°C磷酸盐缓冲盐水的离心管中,并与制冷剂一起放入有缓冲垫的聚苯乙烯泡沫塑料盒中,然后运至我院。到达我院后立即提取睾丸精子。同一天进行取卵,提取成熟卵母细胞,然后通过常规ICSI进行授精。受精卵培养2天,然后将分裂胚胎冷冻保存。在一例中冷冻保存4个月后,另一例冷冻保存2个月后,进行冻融胚胎移植。
两名患者均成功妊娠并诞下正常、健康的婴儿。
这些结果表明,在小型单一科室的妇产科诊所,与泌尿外科合作,通过冷藏运输曲细精管,梗阻性无精子症病例可采用ICSI进行治疗。