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在非阻塞性阿佐精子症中,丸活检后的酶性组织处理增强了精子检索能力

V Vloeberghs¹, N De Munck¹, A Racca²

¹Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Human reproduction open

|November 8, 2023

概括

丸活检的酶性处理显著增加了非阻塞性精子缺血症 (NOA) 患者的精子检索率. 然而,通过酶性消化成功的精子提取可能与相比仅用机械割相比,累积活产率较低的相关性.

科学领域:

生殖医学生殖医学
安德罗学与人类学
在体外受精实验室技术实验室技术

背景情况:

在非阻塞性亚精子症 (NOA) 中丸精子检索 (SR) 的外科手术方法得到了充分研究,但最佳实验室方案仍在争论中.
很少有研究研究实验室程序的影响,如酶性消化,在NOA患者的SR率.

研究的目的:

评估丸活检酶处理对诊断为非阻塞性精子缺血症 (NOA) 的患者精子检索 (SR) 率的附加值.
评估酶性消化对在细胞内精子注射 (ICSI) 后累积活产 (CLB) 率的影响.

主要方法:

一项回顾性单中心队列研究包括了118名NOA患者,他们在2004-2022年期间接受了他们的第一个TESE.
丸活检是通过机械割处理的,如果初始SR不足,则使用酶消化 (Collagenase type IV).
多变量回归分析调整了男性FSH,女性年龄,以及对酶消化的要求,以预测CLB.

主要成果:

酶性消化增加了SR率,从44/90 (48.9%) 需要它的患者中提取精子,而仅用切碎时则是28/118 (23.7%).
当精子需要酶消化 (31.8%) 与单独切碎 (64.3%) 时,累积活产率较低.
多变量分析表明,需要酶性消化与每次TESE的CLB显著下降有关 (OR:0.23,P=0.01).

结论:

丸活检的酶处理提高了NOA患者的SR率,强调了优化实验室协议的重要性.
对于SR需要酶化消化的患者,应就潜在较低的累积活产机会进行咨询.
这项研究的回顾性设计是一个局限性,但通过专注于NOA患者的第一个TESE,以正常的核型和没有Y-q删除,这些发现得到了加强.

关键词:

这里是TESE.累积活产分娩是指活产分娩的累积分娩.酶性消化酶性消化非阻塞性阿佐精子症.精子采集精子采集

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