Role of tissue digestion and extensive sperm search after microdissection testicular sperm extraction
Role of tissue digestion and extensive sperm search after microdissection testicular sperm extraction
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DOI：
10.1016/j.fertnstert.2011.05.033
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发表时间：
2011-08-01
影响因子：
6.7
通讯作者：
Schlegel, Peter N.
中科院分区：
文献类型：
--
作者：
Ramasamy, Ranjith;Reifsnyder, Jennifer E.;Schlegel, Peter N.
目的：报告在手术室（OR）未识别精子时，在实验室发现精子的机会。设计：临床回顾性研究。设置：三级大学医院泌尿科。患者：共1，054名接受显微解剖睾丸精子提取术的非梗阻性无精子症男性。干预：如果在手术室中没有观察到精子，则在实验室中使用组织消化方案相对于精子识别的机会分析术前和术中参数。主要结果测量：精子回收率、临床妊娠率和活产率。结果：在1,054名男性中，52.5%的人在OR中发现了精子。在501名男性中，男性学家在手术室中没有发现精子，在实验室中发现了另外35名（7%）。多变量Logistic回归分析，生殖细胞的存在是唯一的预测识别精子在实验室后，组织消化。结论（S）：在男性进行显微解剖睾丸精子提取，当精子没有观察到的OR，尽管广泛的机械处理，精子在实验室观察到的男性的7%。这一信息是有价值的咨询夫妇在术后立即期间，没有精子确定术中。（Fertil Steril（R）2011; 96：299-302. (c)美国生殖医学会（American Society for Reproductive Medicine）
Objective: To report the chance of sperm discovery in the laboratory when sperm were not identified in the operating room (OR).Design: Clinical retrospective study.Setting: Department of urology at a tertiary university hospital.Patient(s): A total of 1,054 men with nonobstructive azoospermia who underwent microdissection testicular sperm extraction.Intervention(s): Preoperative and intraoperative parameters were analyzed relative to the chance of sperm identification using a tissue digestion protocol in the laboratory if no sperm were observed in the OR.Main Outcome Measure(s): Sperm retrieval, clinical pregnancy, and live birth rates.Result(s): Sperm were found in the OR in 52.5% of the 1,054 men. Of the 501 men for whom sperm were not identified by andrologists in the OR, sperm were found in the laboratory for an additional 35 (7%). On multivariable logistic regression analysis, the presence of germ cells intraoperatively was the only predictor of identifying sperm in the laboratory after tissue digestion.Conclusion(s): In men undergoing microdissection testicular sperm extraction, when sperm were not observed in the OR despite extensive mechanical processing, sperm were observed in the laboratory for 7% of the men. This information is valuable in counseling couples in the immediate postoperative period when no sperm were identified intraoperatively. (Fertil Steril (R) 2011; 96: 299-302. (c) 2011 by American Society for Reproductive Medicine.)