Banerjee Kaberi, Singla Bhavana, Agria Kiran
Medical Director, Department of Reproductive Medicine, Advance Fertililty and Gynaecology Center, New Delhi, India.
Senior Consultant, Department of Reproductive Medicine, Advance Fertililty and Gynaecology Center, New Delhi, India.
Indian J Endocrinol Metab. 2023 Mar-Apr;27(2):167-169. doi: 10.4103/ijem.ijem_194_22. Epub 2023 Apr 14.
Sperm retrieval from men with azoospermia has evolved in recent times, providing patient hope for fulfilling their dream of having their own genetic child through testicular sperm extraction followed by intracytoplasmic sperm injection (TESE-ICSI). In the present study, we are correlating the serum follicle stimulating hormone (FSH) levels and the rate of testicular sperm retrieval.
To correlate the serum FSH levels with surgically retrieved sperms from testes in non-obstructive azoospermia.
Sixty-six men presenting with male infertility, diagnosed with non-obstructive azoospermia based on standard guidelines were included in the study. The surgically retrieved tissue was washed in 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES) gamete buffer media and scanned under an inverted microscope at ×400. Outcome analysis was assessed through sperm retrieval rate.
Testicular sperms were successfully retrieved in 62% (41/66) of men. Sperm retrieval rate (SRR) with FSH values (Group A <10, Group B 10-20 and Group C >20) mIU/mL were 84% (26/31), 75% (12/16) and 15% (3/19), respectively.
Chances of sperm retrieval in non-obstructive azoospermia using surgically retrieved sperm are as common for men with FSH levels <10 mIU/mL with 84% (26/31) retrieval as for the borderline 10-20 mIU/mL FSH levels with 75% (12/16) retrieval. We do have retrieved sperms with >20 IU/mL serum FSH also which is not a contradiction for TESE for such patients; however, such patient's need to be counselled about the chances of successful sperm retrieval and the consequent pregnancy outcomes.
近年来,从无精子症男性中获取精子的技术不断发展,通过睾丸精子提取术(TESE)及随后的卵胞浆内单精子注射技术(ICSI),为患者实现拥有自己亲生孩子的梦想带来了希望。在本研究中,我们将血清促卵泡生成素(FSH)水平与睾丸精子获取率进行关联分析。
将非梗阻性无精子症患者的血清FSH水平与手术获取的睾丸精子进行关联分析。
本研究纳入了66例根据标准指南诊断为非梗阻性无精子症的男性不育患者。手术获取的组织在4-(2-羟乙基)-1-哌嗪乙磺酸(HEPES)配子缓冲培养基中洗涤,并在倒置显微镜下以×400倍进行扫描。通过精子获取率进行结果分析。
62%(41/66)的男性成功获取了睾丸精子。FSH值分组(A组<10、B组10 - 20和C组>20)mIU/mL时的精子获取率(SRR)分别为84%(26/31)、75%(12/16)和15%(3/19)。
对于FSH水平<10 mIU/mL的非梗阻性无精子症男性,手术获取精子的成功率为84%(26/31),与FSH水平处于临界值10 - 20 mIU/mL且成功率为75%(12/16)的情况相当。我们也确实从血清FSH>20 IU/mL的患者中获取到了精子,对于此类患者进行TESE并非矛盾之举;然而,需要就此类患者成功获取精子的几率及随之而来的妊娠结局对其进行咨询。