在预测丸精子提取成功的丸组织学失败率
Stefano Castellano1, Francesca Tondo1, Ozgur Bulbul1
1Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy.
Frontiers in endocrinology
|October 25, 2024
概括
丸精子提取 (TESE) 与组织学相结合,可以改善亚精子症的诊断. 当组织学错过它们时,TESE通常会找到精子,这有助于对男性不孕症的治疗决定.
科学领域:
- 生殖医学 生殖医学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 安德罗学与人类学
背景情况:
- 非阻性亚精子症 (NOA) 和阻性亚精子症 (OA) 的管理涉及丸精子提取 (TESE) 和细胞内质精子注射 (ICSI).
- 预测NOA患者的精子获取成功对于患者咨询至关重要,因为目前的成功率约为50%.
- 虽然已经研究了FSH水平等因素,但丸活检 (组织学) 通常被认为是预测TESE结果的黄金标准.
研究的目的:
- 为了比较丸精子提取 (TESE) 的诊断准确性与阿佐精子症患者的传统丸组织学.
- 评估TESE发现和组织学分析之间的一致性和不一致率.
- 为了确定对亚精子症的诊断方法的潜在改进.
主要方法:
- 对接受TESE的526名患者进行了回顾性分析.
- 丸组织被分为两个样本:一个用于立即胚胎学家评估冷保存 (TESE),另一个用于组织学分析.
- 使用分数系统来比较TESE和组织学结果.
主要成果:
- 在TESE和丸组织学结果之间有70.7%的一致性.
- 在29.3%的病例中观察到不一致.
- 在95%的不一致病例中,TESE成功识别了精子,而组织学没有,或发现数量不足.
结论:
- 丸精子提取 (TESE) 在检测亚精子患者的精子时可能比组织学更敏感.
- 建议包括发送较大的活检样本用于组织病理学或使用TESE细胞悬浮液用于细胞学评估精子生成,以提高诊断准确度.
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