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題 名 | Surgical and Pathologic Observations of Epididymal Tubules during Microscopic Epididymal Sperm Aspiration for Intracytoplasmic Sperm Injection=為卵細胞質內精蟲注射所做副睪顯微取精時對副睪小管所做的外科病理觀察 |
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作 者 | 江漢聲; 劉志鴻; 曾啟瑞; 方嘉郎; | 書刊名 | 臺灣醫學會雜誌 |
卷 期 | 97:12 1998.12[民87.12] |
頁 次 | 頁838-844 |
分類號 | 416.275 |
關鍵詞 | 卵細胞質; 精蟲; 副睪顯微取精; 副睪小管; 外科病理; 觀察; Microscopic epididymal sperm aspiration; Intracytoplasmic sperm injection; Obstructive azoospermia; Testicular sperm extraction; Male infertility; |
語 文 | 英文(English) |
英文摘要 | microscopic epididymal sperm aspiration (MESA) for sperm retrieval and intracytoplasmic sperm injection (JCSI) is currently our routine treatment for selected male patients with obstructive azoospermia. In order to refine the surgical technique and obtain better quality for our assisted reproductive technology program, we observed the epididymal tubules in 40 sessions of surgical exploration of the epididymis for sperm aspiration. Epididymal tubules with long-term obstruction could be divided into three groups on the basis of clinical observations and pathology findings: markedly dilated, mildly dilated, and nondilated. All of the markedly dilated epididymal tubules (grade III,n=10) were azoopspermic and ICSI could not be done. Epididymal sperm obtained from the mildly dilated tubules (grade II, n=9) resulted in poorer fertilization (49%) and pregnancy (33%) rates than sperm obtained from nondilated epididymal tubules (grade I, n=21, fertilization rate 72%, pregnanc rate 57%). These findings demonstrate that nondilated epididymal tubules are best for sperm retrieval and successful ICSI. We believe this observation will be a good surgical parameter for urologic surgeons performing MESA. |
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