Tzeng C R, Hsiao S Y, Chien L W, Chang S R, Chiang H S, Wu C C, Chen A C
Department of Obstetrics and Gynecology, Taipei Medical College Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1996 Feb;57(2):161-4.
Congenital absence of the vas deferens (CAVD) has been considered a virtually untreatable cause of male infertility. Men with this condition have been shown on testicular biopsy to have adequate spermatogenesis, and are theoretically producing sperm capable of fertilizing an oocyte. Yet epididymal transit was thought to be essential for the maturation of spermatozoa and development of their fertilizing ability since the characteristics of sperm motility improve as the sperm passes through the cauda. However recent studies in man have shown that spermatozoa aspirated from the obstructed caput epididymis and ductuli efferentia are, in fact, capable of fertilization in vitro. Microsurgical epididymal sperm aspiration (MESA) from the proximal region (caput) of the epididymis, obtained 0.5 x 10(6) sperm per ml, following washing and direct swim-up. Twelve oocytes were inseminated and three embryos were generated for transfer. The patient conceived and delivered a healthy female baby weighting 2838 gm, on March 3, 1994. This is the first documentation in Taiwan of live birth resulting from MESA from a patient with CAVD combined with in vitro fertilization and embryo transfer.
先天性输精管缺如（CAVD）一直被认为是男性不育几乎无法治疗的原因。对患有这种疾病的男性进行睾丸活检显示，其有足够的精子发生，理论上能产生可使卵母细胞受精的精子。然而，由于精子在通过附睾尾时其运动特性会改善，所以附睾转运被认为对精子成熟及其受精能力的发展至关重要。然而，最近对人类的研究表明，从阻塞的附睾头和输出小管吸出的精子实际上能够在体外受精。通过显微外科手术从附睾近端（附睾头）吸取精子（MESA），冲洗并直接上游后每毫升可获得0.5×10⁶个精子。对12个卵母细胞进行了授精，产生了3个用于移植的胚胎。该患者于1994年3月3日受孕并产下一名体重2838克的健康女婴。这是台湾首例关于CAVD患者通过MESA联合体外受精和胚胎移植实现活产的记录。
