附睾微穿刺结合体外受精和卵母细胞显微操作治疗不可重建性梗阻性无精子症。

Epididymal micropuncture with in vitro fertilization and oocyte micromanipulation for the treatment of unreconstructable obstructive azoospermia.

作者信息

Schlegel P N, Berkeley A S, Goldstein M, Cohen J, Alikani M, Adler A, Gilbert B R, Rosenwaks Z

机构信息

James Buchanan Brady Foundation, Department of Urology, New York Hospital-Cornell Medical Center 10021.

出版信息

Fertil Steril. 1994 May;61(5):895-901. doi: 10.1016/s0015-0282(16)56703-x.

OBJECTIVE

To provide fertility to couples in whom the man has surgically unreconstructable obstructive azoospermia.

DESIGN

Prospective.

SETTING

Hospital-based IVF unit, including associated division of urologic microsurgery.

PATIENTS

Couples referred to our fertility unit for treatment of men with surgically unreconstructable reproductive tract obstruction, including congenital absence of the vas deferens.

MAIN OUTCOME MEASURES

Fertilization, pregnancies, and live births.

RESULTS

Of 51 cycles in which sperm and eggs were retrieved, 67% (34/51) resulted in fertilization and 27.5% (14/51) developed clinical pregnancy. Clinical pregnancy rate per couple was 33% (14/43). A total of 15 live births have been obtained in 11 couples with one ongoing pregnancy. Epididymal length was the best predictor of sperm quality and pregnancy results. For couples with at least the corpus epididymis present, 41% (9/22) of cycles resulted in clinical pregnancies.

CONCLUSIONS

Pregnancy rates are optimized using sperm retrieved from the epididymis by micropuncture and when micromanipulation is available for use during IVF.

目的

为男方患有手术无法重建的梗阻性无精子症的夫妇提供生育能力。

设计

前瞻性研究。

地点

以医院为基础的体外受精科室，包括相关的泌尿外科显微手术科室。

患者

因男方患有手术无法重建的生殖道梗阻（包括先天性输精管缺如）而转诊至我们生育科室接受治疗的夫妇。

主要观察指标

受精、妊娠和活产。

结果

在51个取精取卵周期中，67%（34/51）实现受精，27.5%（14/51）临床妊娠。每对夫妇的临床妊娠率为33%（14/43）。11对夫妇共获得15例活产，1例仍在妊娠中。附睾长度是精子质量和妊娠结果的最佳预测指标。对于至少存在附睾体的夫妇，41%（9/22）的周期临床妊娠。

结论

通过附睾微穿刺取精，并在体外受精过程中采用显微操作技术，可优化妊娠率。