Ozmerdiven Gokhun, Guler Yavuz, Sahin Eren, Tatar Zeynep, Erbin Akif, Dirican Ebubekir, Haliloglu Ahmet Hakan
Department of Urology, Istanbul Aydin University, Medical Faculty Istanbul, Turkey.
Department of Urology, Private Safa Hospital Istanbul, Turkey.
Am J Clin Exp Urol. 2021 Dec 15;9(6):469-478. eCollection 2021.
If spermatozoa cannot be found after testiculer sperm extraction (TESE) in patients followed up due to nonobstructive azospermia (NOA) and the patients do not want donor spermatozoa, performance of round spermatid injection (ROSI) with the current technology seems to be the last resort. This retrospective study was conducted to evaluate the effect of testicular morphology on the development of embryos to the blastocyst stage obtained from ROSI. Between September 2019 and March 2020, after TESE and biopsy 29 patients who had only spermatid were taken to study. Tubular appearance, basal membrane appearance, Johnson score, peritubular fibrosis, interstitial fibrosis, and Leydig cell proliferation were pathologically examined. Following egg collection, ROSI was applied to the oocytes using the piezoelectric method. The embryos were monitored until the blastocyst stage. The mean age of the 29 patients was 36.3±5.01 years. Also, 7 patients had not previously undergone TESE, 20 had previously undergone once, and 2 had previously undergone twice. It was observed that having a history of TESE and a high Johnson score increased the likelihood of the embryo remaining in the blastocyst stage (P=0.021 and 0.014, respectively). However, other parameters do not affect the likelihood of blastocyst formation (P>0.05). Low TESE history and high Johnson score were associated with embryo development to the blastocyst stage. If spermatozoa are not found in patients with nonobstructive azoospermia, ROSI performed during initial TESE increases the likelihood of blastocyst formation.
对于因非梗阻性无精子症（NOA）接受随访的患者，若在睾丸精子提取（TESE）后未发现精子，且患者不想要供体精子，那么采用当前技术进行圆形精子细胞注射（ROSI）似乎是最后的手段。本回顾性研究旨在评估睾丸形态对通过ROSI获得的胚胎发育至囊胚阶段的影响。2019年9月至2020年3月期间，对29例仅含有精子细胞的患者进行TESE和活检后纳入研究。对小管外观、基底膜外观、约翰逊评分、管周纤维化、间质纤维化和睾丸间质细胞增殖进行病理检查。取卵后，采用压电方法对卵母细胞进行ROSI。监测胚胎直至囊胚阶段。29例患者的平均年龄为36.3±5.01岁。此外，7例患者此前未接受过TESE，20例曾接受过一次，2例曾接受过两次。观察到有TESE病史和较高的约翰逊评分会增加胚胎留在囊胚阶段的可能性（分别为P = 0.021和0.014）。然而，其他参数不影响囊胚形成的可能性（P>0.05）。低TESE病史和高约翰逊评分与胚胎发育至囊胚阶段相关。对于非梗阻性无精子症患者，若未发现精子，在初次TESE期间进行ROSI可增加囊胚形成的可能性。
