Tournaye H, Liu J, Nagy P Z, Camus M, Goossens A, Silber S, Van Steirteghem A C, Devroey P
Department of Human Pathology, University Hospital, Dutch-speaking Brussels Free University (Vrije Universiteit Brussel), Laarbeeklaan 101, B-1090 Brussels, Belgium.
Hum Reprod. 1996 Jan;11(1):127-32. doi: 10.1093/oxfordjournals.humrep.a019004.
A comprehensive study is presented of a series of 124 infertile men undergoing testicular sperm retrieval for intracytoplasmic sperm injection (ICSI). In this study we correlated the histological changes observed in the testicular tissue with the results of the wet preparation and the outcome after ICSI using testicular spermatozoa. In all patients with normal spermatogenesis and hypospermatogenesis spermatozoa were recovered from the wet preparation. The sperm recovery rate as 84% in patients with incomplete germ-cell-aplasia and maturation arrest, while in patients with complete germ-cell aplasia or maturation arrest this figure was 76%. In these patients more specimens were sampled and fewer spermatozoa were recovered. Since no spermatozoa were recovered in only 10 patients, ICSI with testicular sperm was performed in the remaining 114 couples (91.9%). The normal fertilization rate was 57. 8%. The fertilization rate was significantly lower in couples among whom the husband showed germ-cell aplasia and maturation arrest. Overall, 55.2% of normally fertilized oocytes developed into embryos showing <=50% of anucleate fragments. There were no major differences between the different histological categories in terms of embryonic development in vitro. The overall pregnancy rates per testicular sperm extraction (TESE) procedure, per ICSI procedure and per transfer were respectively 36.3, 39.5 and 43.7%. The overall implantation rate per embryo (sacs/embryos replaced) was 20.3%. A lower implantation rate was observed in couples among whom the husband had maturation arrest (not statistically significant). The above data show that testicular biopsies may have an important therapeutic role in the management of infertility in azoospermic patients.
本文对124例接受睾丸精子提取用于卵胞浆内单精子注射（ICSI）的不育男性进行了一项综合研究。在本研究中，我们将睾丸组织中观察到的组织学变化与湿片制备结果以及使用睾丸精子进行ICSI后的结果进行了关联。在所有精子发生正常和精子发生低下的患者中，均从湿片中回收了精子。在不完全生精细胞发育不全和成熟停滞的患者中，精子回收率为84%，而在完全生精细胞发育不全或成熟停滞的患者中，这一数字为76%。在这些患者中，取样的标本更多，但回收的精子更少。由于仅10例患者未回收精子，其余114对夫妇（91.9%）进行了睾丸精子ICSI。正常受精率为57.8%。丈夫表现为生精细胞发育不全和成熟停滞的夫妇的受精率显著较低。总体而言，55.2%正常受精的卵母细胞发育成无核碎片≤50%的胚胎。在体外胚胎发育方面，不同组织学类别之间没有重大差异。每次睾丸精子提取（TESE）程序、每次ICSI程序和每次移植的总体妊娠率分别为36.3%、39.5%和43.7%。每个胚胎（移植囊胚/胚胎）的总体着床率为20.3%。在丈夫有成熟停滞的夫妇中观察到较低的着床率（无统计学意义）。上述数据表明，睾丸活检在无精子症患者的不育治疗中可能具有重要作用。
