Hakim L S, Lobel S M, Oates R D
Department of Urology, Boston University School of Medicine, Massachusetts 02118, USA.
Fertil Steril. 1995 Dec;64(6):1141-6. doi: 10.1016/s0015-0282(16)57975-8.
To evaluate the success of electroejaculation with assisted reproductive technologies (ART) in anejaculate men after retroperitoneal lymph node dissection (RPLND) for testicular cancer.
Retrospective clinical study.
Tertiary care, university-affiliated IVF program.
Anejaculate men after RPLND, spouses.
Electroejaculation, microsurgical sperm aspiration, various assisted reproductive technologies.
Sperm density and motility, fertilization rate, pregnancy rate (PR).
Compared with patients not receiving chemotherapy, patients who received chemotherapy had diminished average sperm densities and motilities (63 x 10(6) and 20% versus 101 x 10(6) 32%, respectively); decreased fertilization rates per cycle for IVF and intracytoplasmic sperm injection (ICSI) (11% versus 26%, respectively); lower PRs per cycle of hMG-IUI and IVF (14% versus 60% and 8% versus 50%, respectively). No pregnancies were achieved with natural cycle-IUI, clomiphene citrate-IUI, or GIFT. Two couples progressed to intracytoplasmic sperm injection with one achieving the successful delivery of healthy twins. The overall PR per cycle was 22%.
Patients receiving chemotherapy had decreased sperm densities, motilities, fertilization, and PRs for each modality used. Rectal probe electroejaculation with ART can help anejaculate men after RPLND achieve biologic paternity. An early move to the more aggressive therapies (hMG-IUI, IVF, ICSI) is supported.
评估在睾丸癌腹膜后淋巴结清扫术（RPLND）后射精功能丧失的男性中，辅助生殖技术（ART）进行电射精的成功率。
回顾性临床研究。
三级医疗、大学附属体外受精项目。
RPLND后射精功能丧失的男性及其配偶。
电射精、显微外科精子抽吸术、各种辅助生殖技术。
精子密度和活力、受精率、妊娠率（PR）。
与未接受化疗的患者相比，接受化疗的患者平均精子密度和活力降低（分别为63×10⁶和20%，而未化疗患者分别为101×10⁶和32%）；体外受精（IVF）和卵胞浆内单精子注射（ICSI）每个周期的受精率降低（分别为11%和26%）；人绝经期促性腺激素宫内人工授精（hMG-IUI）和IVF每个周期的PR降低（分别为14%和60%以及8%和50%）。自然周期-IUI、枸橼酸氯米芬-IUI或配子输卵管内移植（GIFT）均未实现妊娠。两对夫妇进行了ICSI，其中一对成功分娩了健康双胞胎。每个周期的总体PR为22%。
接受化疗的患者每种使用的方式的精子密度、活力、受精率和PR均降低。ART联合直肠探头电射精可帮助RPLND后射精功能丧失的男性实现生物学父权。支持尽早采用更积极的治疗方法（hMG-IUI、IVF、ICSI）。
