Sigman M
Division of Urology, Brown University School of Medicine, Providence, Rhode Island.
Urol Clin North Am. 1994 Aug;21(3):505-15.
For couples in whom improvement in spermatogenesis is not possible or is unsuccessful in producing conception, ARTs offer much promise. For mild to moderate male factor couples, IUI combined with superovulation is often the initial procedure employed. If unsuccessful, IVF or one of its variations should be considered. With severe male factor cases, couples should proceed directly to IVF or one of its variations in which specific techniques may be used to improve the chances of fertilization. Currently both specialized semen-processing techniques and micromanipulation are used either singly or in combination. More experience is needed to determine which couples will benefit from which techniques. Although the urologist may not actively participate in all the actual ART procedures, it is important that the urologist have a thorough understanding of the procedures and their indications. This allows for accurate counseling of the male factor couple.
对于那些精子发生无法改善或改善后仍无法受孕的夫妇，辅助生殖技术带来了很大希望。对于轻度至中度男性因素导致的不育夫妇，宫腔内人工授精（IUI）联合促排卵通常是首先采用的方法。如果不成功，则应考虑体外受精（IVF）或其某种变体。对于严重男性因素导致的不育病例，夫妇应直接进行IVF或其某种变体，其中可使用特定技术来提高受精几率。目前，专门的精液处理技术和显微操作技术既可以单独使用，也可以联合使用。需要更多经验来确定哪些夫妇将从哪些技术中受益。虽然泌尿外科医生可能不会积极参与所有实际的辅助生殖技术程序，但泌尿外科医生全面了解这些程序及其适应症很重要。这有助于为男性因素不育夫妇提供准确的咨询。
