Yamamoto M, Hibi H, Miyake K, Asada Y, Suganuma N, Tomoda Y
Department of Urology, Nagoya University School of Medicine, Japan.
Arch Androl. 1996 May-Jun;36(3):217-24. doi: 10.3109/01485019608987098.
A novel sperm collection method by epididymal micropuncture combined with perivascular nerve stimulation has been developed to obtain as many clean sperm as possible for IVF for patients with surgically irreparable vasal obstruction. To assess whether the new technique could improve the fertilization and pregnancy rates obtained when attempting microsurgical epididymal sperm aspiration (MESA) to retrieve epididymal sperm from such patients, a prospective randomized comparative study was conducted. Twenty-nine cycles of conventional MESA with ICSI were performed on 25 couples with congenital bilateral absence of the vas deferens (CBAVD) and four failed vasovasostomy cases (group 1). Thirty cycles of epididymal micropuncture with nerve stimulation with ICSI were performed on 28 couples with CBAVD and two failed epididymovasostomy cases (group 2). The mean volume of epididymal fluid and sperm motility in group 2 was significantly higher than that in group 1 (p < .001). Both fertilization and pregnancy rates in group 2 were significantly higher than those in group 1 (p < .001 and p < .03). This novel epididymal sperm collection method for ICSI can provide significantly higher fertilization and pregnancy rates than conventional MESA for ICSI.
一种通过附睾微穿刺结合血管周围神经刺激的新型精子采集方法已被开发出来，以便为患有手术无法修复的输精管阻塞的患者获取尽可能多的纯净精子用于体外受精（IVF）。为了评估这项新技术能否提高对这类患者进行显微外科附睾精子抽吸术（MESA）获取附睾精子时的受精率和妊娠率，开展了一项前瞻性随机对照研究。对25对先天性双侧输精管缺如（CBAVD）夫妇和4例输精管吻合术失败病例进行了29个周期的常规MESA联合卵胞浆内单精子注射（ICSI）（第1组）。对28对CBAVD夫妇和2例附睾输精管吻合术失败病例进行了30个周期的附睾微穿刺联合神经刺激及ICSI（第2组）。第2组附睾液平均体积和精子活力显著高于第1组（p < 0.001）。第2组的受精率和妊娠率均显著高于第1组（p < 0.001和p < 0.03）。这种用于ICSI的新型附睾精子采集方法比常规MESA联合ICSI能提供显著更高的受精率和妊娠率。
