A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia
A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia
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DOI：
10.1093/humrep/13.11.3075
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发表时间：
1998-11-01
影响因子：
6.1
通讯作者：
Cooke, ID
中科院分区：
文献类型：
--
作者：
Ezeh, UIO;Moore, HDM;Cooke, ID
对于生精缺陷的无精子症男性，细针抽吸睾丸活检取精的有效性和影响结果的因素知之甚少。一项前瞻性研究旨在比较35例连续的因精子发生缺陷而接受睾丸活检卵母细胞胞浆内注射的无精子症男性中，针式和开放式（窗口）睾丸活检用于睾丸附睾精子提取（TESE）的有效性，连续35例患者均使用19号蝶形针进行TESE，然后在同一程序中进行窗口（1-1.5 cm大小的切口）睾丸活检。将精子提取到培养基中与通过组织学评估睾丸活检、活检模式（穿刺活检或开放式活检）和通过任一方法获取的组织量进行比较。22例（63%）开放性睾丸活检患者和5例（14%）多针穿刺活检患者分别获得了睾丸精子;差异具有统计学意义。开放式睾丸活检比针吸活检获得更多的睾丸组织。睾丸穿刺活检在精子生成不足的患者中回收了50%的睾丸精子，在局灶性精子生成的患者中回收了10%的睾丸精子，而在成熟停滞或仅支持细胞类型的患者中没有精子回收。相反，在各自的组织学类型的患者中，使用睾丸开放活检回收精子的成功率分别为100%、90%和66%。除了不需要止痛的瘀伤外，没有一个患者出现与传统睾丸活检相关的明显并发症。我们的结论是，开放睾丸活检是更有效的比针吸活检的无精子症男性精子发生缺陷的睾丸精子的检索。观察到的差异可能与睾丸组织的数量和睾丸组织学的影响有关。
Little is known about the efficacy and the factors affecting the outcome of fine needle aspiration biopsy of the testis for sperm retrieval in azoospermic men with defective spermatogenesis. A prospective study was designed to compare the efficacy of needle and open (window) testicular biopsies for testicular epididymal sperm extraction (TESE) in 35 consecutive men with azoospermia due to defective spermatogenesis undergoing testicular biopsy for intracytoplasmic injection of oocytes, Each of the consecutive 35 patients underwent TESE using a 19 gauge butterfly needle followed by a window (1-1.5 cm-sized incision) testicular biopsy in the same procedure. The extraction of spermatozoa into culture medium was compared with the assessment of testicular biopsies by histology, the mode of biopsy (needle or open biopsy) and the amount of tissue retrieved by either method. Testicular spermatozoa were retrieved in 22 (63%) who had an open testicular biopsy compared with five (14%) patients who had multiple needle biopsies, respectively; the difference was statistically significant. Open testicular biopsy retrieves more testicular tissue than needle biopsy. Needle testicular biopsy retrieved testicular spermatozoa in 50% of those with hypospermatogenesis, 10% with focal spermatogenesis and in no patients with maturation arrest or Sertoli cell-only pattern, In contrast, sperm retrieval was successful in 100%, 90% and 66% of those with respective histologies using open testicular biopsy. Other than bruising, for which they required no analgesia, none of the patients suffered any obvious complications associated with traditional testicular biopsy. We conclude that open testicular biopsy is more effective than needle biopsy for the retrieval of testicular spermatozoa in azoospermic men with defective spermatogenesis. The difference observed may be related to the amount of testicular tissue retrieved and to the influence of testicular histology.