Belker A M, Sherins R J, Dennison-Lagos L, Thorsell L P, Schulman J D
Department of Surgery, University of Louisville School of Medicine, Kentucky, USA.
J Urol. 1998 Dec;160(6 Pt 1):2058-62.
After intracytoplasmic sperm injection was established to facilitate in vitro fertilization in men with the most severe semen abnormalities, the use of testicular sperm to achieve conception became feasible. We investigated the use of a method of percutaneous needle aspiration previously used for diagnostic purposes to obtain testicular sperm for intracytoplasmic sperm injection.
A method of percutaneous aspiration of sperm was developed to facilitate intracytoplasmic sperm injection. A total of 69 testicular aspirations were performed for diagnostic purposes and 179 to obtain sperm on the day of egg retrieval for couples undergoing in vitro fertilization with intracytoplasmic sperm injection. The procedures were performed in an outpatient facility. Most patients received intravenous sedation and a few received only local anesthesia.
Sperm adequate for intracytoplasmic sperm injection were obtained in all men with obstructive azoospermia, including those with significant testicular atrophy and those with anejaculation or necrospermia. Adequate numbers of sperm for intracytoplasmic sperm injection were retrieved less reliably in men with nonobstructive azoospermia. The number of sperm correlated positively with testicular size. Morbidity and discomfort were nonexistent. Sperm were obtained from 43 of 69 men undergoing diagnostic and 170 of 179 men undergoing therapeutic aspiration. Sperm motility ranged from 0 to 20% and viability from 55 to 85%.
Percutaneous testicular sperm aspiration is a cost-effective method to retrieve sperm for intracytoplasmic sperm injection in select men with obstructive azoospermia, anejaculation and necrospermia, and some with nonobstructive azoospermia.
在建立卵胞浆内单精子注射技术以促进精液异常最为严重的男性进行体外受精后，利用睾丸精子实现受孕变得可行。我们研究了一种先前用于诊断目的的经皮穿刺抽吸方法，以获取用于卵胞浆内单精子注射的睾丸精子。
开发了一种经皮精子抽吸方法以促进卵胞浆内单精子注射。总共进行了69次睾丸抽吸用于诊断目的，179次在取卵日获取精子，用于接受卵胞浆内单精子注射体外受精的夫妇。这些操作在门诊机构进行。大多数患者接受静脉镇静，少数仅接受局部麻醉。
在所有梗阻性无精子症男性中均获取到了足以用于卵胞浆内单精子注射的精子，包括那些睾丸明显萎缩以及存在不射精或死精症的男性。在非梗阻性无精子症男性中，获取足够数量用于卵胞浆内单精子注射的精子的可靠性较低。精子数量与睾丸大小呈正相关。未出现并发症和不适。在69名接受诊断性抽吸的男性中有43名获取到了精子，在179名接受治疗性抽吸的男性中有170名获取到了精子。精子活力范围为0%至20%，存活率为55%至85%。
经皮睾丸精子抽吸术是一种经济有效的方法，可用于为特定的梗阻性无精子症、不射精和死精症男性以及部分非梗阻性无精子症男性获取用于卵胞浆内单精子注射的精子。
