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[用于生育力保存的人类精子或睾丸组织的冷冻保存]

[Cryopreservation of human spermatozoa or testicular tissue for fertility preservation].

作者信息

Bier Simone, Kliesch Sabine

机构信息

Abteilung für Klinische und Operative Andrologie, Centrum für Reproduktionsmedizin und Andrologie, WHO-Kooperationszentrum, EAA-Ausbildungszentrum, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude D11 (Domagkstraße 11), 48149, Münster, Deutschland.

出版信息

Urologie. 2024 Nov;63(11):1089-1096. doi: 10.1007/s00120-024-02456-7. Epub 2024 Oct 23.

Abstract

Loss of reproductive capacity due to treatments for malignant or non-malignant diseases or even as a result of diseases themselves significantly impacts patients' quality of life. Cryopreservation of sperm from ejaculate is a well-established procedure for preserving the fertility of these patients and thus improving their quality of life in the long term. If cryopreservation of sperm from ejaculate is not possible, either because ejaculation cannot occur or no sperm can be found in the ejaculate, the preferred treatment option is (microsurgical) testicular sperm extraction (mTESE). Testicular sperm and ejaculated spermatozoa can be cryopreserved and later used for intracytoplasmic sperm injection (ICSI) treatment. The use of cryopreserved sperm for fertility treatment does not carry an increased risk of malformations in the offspring. If gonadotoxic therapy is necessary in pre- or early pubertal boys, the only option to preserve fertility in the long term is to cryopreserve spermatogonial stem cells from testicular tissue as part of the Androprotect© network. This is an experimental approach which has been available since 2012 across Germany and which is accompanied by intensive scientific work ( www.androprotect.de ).

摘要

因恶性或非恶性疾病的治疗甚至疾病本身导致的生殖能力丧失,会对患者的生活质量产生重大影响。冷冻保存射出精液中的精子是一种成熟的程序,可用于保存这些患者的生育能力,从而从长远改善他们的生活质量。如果无法冷冻保存射出精液中的精子,原因可能是无法射精或精液中找不到精子,那么首选的治疗方案是(显微外科)睾丸精子提取术(mTESE)。睾丸精子和射出的精子均可冷冻保存,随后用于胞浆内单精子注射(ICSI)治疗。使用冷冻保存的精子进行生育治疗不会增加后代出现畸形的风险。如果青春期前或青春期早期的男孩需要进行性腺毒性治疗,长期保存生育能力的唯一选择是作为Androprotect©网络的一部分,冷冻保存睾丸组织中的精原干细胞。这是一种自2012年起在德国各地可用的实验性方法,并且有大量科学研究工作与之相伴(www.androprotect.de)。

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