Physiological consequences of testicular sperm extraction

被引:335
作者
Schlegel, PN [1 ]
Su, LM [1 ]
机构
[1] POPULAT COUNCIL,CTR BIOMED RES,NEW YORK,NY 10021
关键词
azoospermia; infertility; in-vitro fertilization; sperm retrieval; testicular sperm extraction;
D O I
10.1093/humrep/12.8.1688
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Testicular sperm extraction (TESE) may provide spermatozoa for attempts at fertility with assisted reproduction; however the physiological effects of TESE on testicular function are not well understood, In order to evaluate the effects of TESE on the testis, 64 patients were evaluated after TESE for non-obstructive azoospermia with physical examinations, serial scrotal sonography, histological analyses and evaluation of the success of repeated sperm retrieval attempts, At 3 months after TESE, 82% of evaluated patients had ultrasonographic abnormalities in the testis suggesting resolving inflammation or haematoma at the biopsy site, By 6 months, these acute inflammatory changes typically resolved leaving linear scars or calcifications, Two patients had documented impaired testicular blood flow, with complete devascularization of the testis for one patient after TESE with multiple biopsies, Repeat TESE procedures were far more likely to retrieve spermatozoa if the second TESE attempt was performed >6 months after the initial TESE procedure (80%), relative to those performed within 6 months (25%), Transient adverse physiological effects are common in the testis for up to 6 months after TESE, In addition, permanent devascularization of the testis can occur following TESE procedures with multiple biopsies, The risk of this complication may be minimized by using an open biopsy technique with optical magnification to directly identify testicular vessels.
引用
收藏
页码:1688 / 1692
页数:5
相关论文
共 17 条
[1]   ULTRASONOGRAPHY FOR THE DIAGNOSIS AND STAGING OF BLUNT SCROTAL TRAUMA [J].
ANDERSON, KA ;
MCANINCH, JW ;
JEFFREY, RB ;
LAING, FC .
JOURNAL OF UROLOGY, 1983, 130 (05) :933-935
[2]   ACCURACY OF ULTRASOUND DIAGNOSIS AFTER BLUNT TESTICULAR TRAUMA [J].
CORRALES, JG ;
CORBEL, L ;
CIPOLLA, B ;
STAERMAN, F ;
DARNAULT, P ;
GUILLE, F ;
LOBEL, B .
JOURNAL OF UROLOGY, 1993, 150 (06) :1834-1836
[3]   FERTILIZING ABILITY OF TESTICULAR SPERMATOZOA [J].
CRAFT, I ;
BENNETT, V ;
NICHOLSON, N .
LANCET, 1993, 342 (8875) :864-864
[4]  
DELVENTO VR, 1992, AM J VET RES, V53, P2094
[5]   PREGNANCIES AFTER TESTICULAR SPERM EXTRACTION AND INTRACYTOPLASMIC SPERM INJECTION IN NONOBSTRUCTIVE AZOOSPERMIA [J].
DEVROEY, P ;
LIU, J ;
NAGY, Z ;
GOOSSENS, A ;
TOURNAYE, H ;
CAMUS, M ;
VANSTEIRTEGHEM, A ;
SILBER, S .
HUMAN REPRODUCTION, 1995, 10 (06) :1457-1460
[6]   HIGH-RESOLUTION SCROTAL ULTRASONOGRAPHY - A HIGHLY SENSITIVE BUT NONSPECIFIC DIAGNOSTIC-TECHNIQUE [J].
FOURNIER, GR ;
LAING, FC ;
JEFFREY, RB ;
MCANINCH, JW .
JOURNAL OF UROLOGY, 1985, 134 (03) :490-493
[7]  
GilSalom M, 1996, HUM REPROD, V11, P1309
[8]   Percutaneous testis biopsy: An alternative to open testicular biopsy in the evaluation of the subfertile man [J].
Harrington, TG ;
Schauer, D ;
Gilbert, BR .
JOURNAL OF UROLOGY, 1996, 156 (05) :1647-1651
[9]   CLINICAL-SIGNIFICANCE OF INTRATESTICULAR ARTERIAL ANATOMY [J].
JAROW, JP .
JOURNAL OF UROLOGY, 1991, 145 (04) :777-779
[10]  
JOW WW, 1993, J ANDROL, V14, P194