Levine L A, Lisek E W
Department of Urology, Rush-Presbyterian St. Luke's Medical Center, Chicago, Illinois, USA.
J Urol. 1998 Feb;159(2):437-40. doi: 10.1016/s0022-5347(01)63943-0.
We evaluated the safety and efficacy of percutaneous sperm aspiration from the epididymis or testicle as a diagnostic technique to confirm sperm production and as a therapeutic technique to harvest sperm for use in intracytoplasmic sperm injection.
We present our experience with 69 sperm aspiration procedures in men considered to have nonreconstructible obstructive azoospermia. This short outpatient procedure was performed using a butterfly needle with the patient under intravenous sedation and local anesthesia.
Of the 32 diagnostic aspirations 20 demonstrated mature and motile sperm, 9 maturation arrest and 3 germ cell aplasia. In 35 of 37 therapeutic sperm aspirations (95%) adequate samples of sperm after processing (mean of 5.4 million) were obtained. Of 24 epididymal aspirations 13 (54%) had sufficient residual sperm for cryopreservation of 1 to 5 vials (mean 2.5) containing an average of 170,000 sperm per vial. In the 32 intracytoplasmic sperm injection cycles 221 of 392 eggs (56.3%) fertilized (2PN) and 6 resulted in ongoing pregnancies (21.4% per transfer). There have been no acute or chronic complications in this patient population. Ten men underwent a second successful aspiration procedure for intracytoplasmic sperm injection and 3 underwent a third aspiration without added difficulty.
Percutaneous epididymal or testis sperm aspiration is a minimally invasive sperm retrieval technique and appears to be an effective alternative to microsurgical epididymal sperm aspiration, which is more invasive, costly and technically difficult.
我们评估了经皮附睾或睾丸精子抽吸术作为一种诊断技术来确认精子生成以及作为一种治疗技术来获取精子用于胞浆内单精子注射的安全性和有效性。
我们介绍了对69例被认为患有不可重建性梗阻性无精子症男性进行精子抽吸术的经验。该门诊短程手术在患者静脉镇静和局部麻醉下使用蝶形针进行。
在32例诊断性抽吸中，20例显示有成熟且活动的精子，9例为成熟停滞，3例为生殖细胞发育不全。在37例治疗性精子抽吸中的35例（95%），处理后获得了足够的精子样本（平均540万）。在24例附睾抽吸中，13例（54%）有足够的残余精子用于冷冻保存1至5管（平均2.5管），每管平均含有170,000个精子。在32个胞浆内单精子注射周期中，392个卵子中有221个（56.3%）受精（2PN），6例获得持续妊娠（每次移植21.4%）。该患者群体未出现急性或慢性并发症。10名男性为进行胞浆内单精子注射再次成功接受了抽吸手术，3名男性接受了第三次抽吸，未增加难度。
经皮附睾或睾丸精子抽吸术是一种微创的精子获取技术，似乎是显微外科附睾精子抽吸术的有效替代方法，后者具有更高的侵入性、成本更高且技术难度更大。
