Tai Toshihiro, Miyamoto Wakaba, Fukuoka Yuriko, Shibasaki Sena, Takahashi Mizuho, Okuyama Noriyuki, Hattori Hiromitsu, Ishikawa Ikue, Nagaura Satoko, Yoshinaga Koki, Koizumi Masae, Hashimoto Tomoko, Toya Mayumi, Kumagai Jin, Igarashi Hideki, Kyono Koichi
Kyono ART Clinic Sendai Sendai Miyagi Japan.
Kyono ART Clinic Takanawa Tokyo Japan.
Reprod Med Biol. 2024 Mar 11;23(1):e12566. doi: 10.1002/rmb2.12566. eCollection 2024 Jan-Dec.
In microscopic testicular sperm extraction (mTESE) for nonobstructive azoospermia (NOA), sperm can be recovered relatively easily in some cases, and mTESE may be retrospectively considered excessive. However, mTESE is routinely performed in the majority of NOA patients because of the difficulty in predicting tissue status. A minimally invasive and comprehensive sperm retrieval method that allows on-the-spot tissue assessment is needed. We have developed and evaluated a novel sperm retrieval technique for NOA called micromapping testicular sperm extraction (MMTSE).
MMTSE involves dividing the testis into four sections and making multiple small needle holes in the tunica albuginea to extract seminiferous tubules and retrieve sperm. The sperm-positive group by MMTSE (Group I) underwent additional tissue collection (ATC) via a small incision, whereas the sperm-negative group by MMTSE (Group 0) underwent mTESE.
In total, 40 NOA participants underwent MMTSE. Group I included 15 patients and Group 0 included 25 patients. In Group 1, sperm were recovered from all patients by ATC. In Group 0, sperm were recovered in 4 of 25 cases using mTESE.
MMTSE shows promise as a simple method that comprehensively searches testicular tissue and retrieves sperm using an appropriate method while minimizing patient burden.
在针对非梗阻性无精子症（NOA）的显微镜下睾丸精子提取术（mTESE）中，某些情况下精子相对容易获取，mTESE可能在回顾时被认为过度。然而，由于难以预测组织状态，大多数NOA患者仍常规进行mTESE。需要一种微创且能进行现场组织评估的全面精子获取方法。我们开发并评估了一种针对NOA的新型精子获取技术，称为微映射睾丸精子提取术（MMTSE）。
MMTSE包括将睾丸分成四个部分，并在白膜上制造多个小针孔以提取生精小管并获取精子。MMTSE检查出精子阳性的组（第一组）通过小切口进行额外的组织采集（ATC），而MMTSE检查出精子阴性的组（第0组）进行mTESE。
共有40名NOA参与者接受了MMTSE。第一组包括15名患者，第0组包括25名患者。在第一组中，所有患者通过ATC均获取到了精子。在第0组中，25例中有4例通过mTESE获取到了精子。
MMTSE有望成为一种简单的方法，能全面搜索睾丸组织，以适当方法获取精子，同时将患者负担降至最低。
