학술논문
[Micro-dissection testicular sperm extraction for non-obstructive azoospermia patients with the history of secondary testicular injury].
Document Type
Academic Journal
Author
Liu GH; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Zhang J; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Sun GH; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Pang JH; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Wang YD; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Fang C; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Zhang MF; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Gao X; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Chen H; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Kang XM; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Zheng YL; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Sun DJ; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Zeng HT; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Zhao LG; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Wang ZY; Department of Urology, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.; Liang XY; Center of Reproduction, The Sixth Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China.
Source
Publisher: Nanjing Jun Qu Nanjing Zong Yi Yuan zhu ban, Zhonghua Nan Ke Xue Za Zhi Bian Ji Bu bian ji chu ban Country of Publication: China NLM ID: 101093592 Publication Model: Print Cited Medium: Internet ISSN: 1009-3591 (Print) Linking ISSN: 10093591 NLM ISO Abbreviation: Zhonghua Nan Ke Xue Subsets: MEDLINE
Subject
Language
Chinese
ISSN
1009-3591
Abstract
Objective: To investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.
Methods: Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.
Results: Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).
Conclusions: Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.
Methods: Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.
Results: Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).
Conclusions: Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.