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[不育、无精子症男性生精小管细胞学模式在诊断和治疗中的应用]

[Seminiferous tubule cytological pattern in infertile, azoospermic men in diagnosis and therapy].

作者信息

Weiss D B, Gottschalk-Sabag S, Bar-On E, Zukerman Z, Gat Y, Bartoov B

机构信息

Male Infertility Unit, Shaare Zedek Medical Cénter, Jerusalem.

出版信息

Harefuah. 1997 May 1;132(9):614-8, 680.

PMID:9225571
Abstract

We determined spermatogenic patterns of seminiferous tubules in azoospermic infertile men and evaluated the prevalence of bilateral testicular homogeneity. 185 azoospermic men underwent bilateral testicular fine-needle aspiration (TFNA) in which each testis was punctured at 3 different positions. Aspirated material was stained and classified according to the most mature spermatogenic cell type present or whether only Sertoli cells were present. 35.7% had spermatozoa in their testes, 36.2% had spermatogenic maturation arrest, and 28.1% had only Sertoli cells in their seminiferous tubules. In 15.6% of all patients, the diagnosis in 1 testis differed from that in the other. In only 73.2% of those with testicular spermatozoa was it bilateral. In the remaining 26.9%, only Sertoli cells, spermatocytes or spermatids were found as the most mature cell type in the other testis. The study definitely indicates that fertilization with retrieved testicular spermatozoa should not be offered to azoospermic patients without prior evaluation of the seminiferous tubuespermatogenic pattern in both testes.

摘要

我们确定了无精子症不育男性生精小管的生精模式,并评估了双侧睾丸同质性的发生率。185名无精子症男性接受了双侧睾丸细针抽吸术(TFNA),每个睾丸在3个不同位置进行穿刺。抽吸物经染色后,根据存在的最成熟生精细胞类型或是否仅存在支持细胞进行分类。35.7%的患者睾丸中有精子,36.2%有生精成熟停滞,28.1%的生精小管中仅有支持细胞。在所有患者中,15.6%的患者一侧睾丸的诊断与另一侧不同。在仅有睾丸精子的患者中,只有73.2%是双侧的。在其余26.9%的患者中,另一侧睾丸中发现的最成熟细胞类型仅为支持细胞、精母细胞或精子细胞。该研究明确表明,在未事先评估双侧睾丸生精小管生精模式的情况下,不应为无精子症患者提供利用获取的睾丸精子进行受精的治疗。

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