借助睾丸形态预测辅助生殖技术的成功

N. Kulchenko
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引用次数: 3

摘要

在结构不孕症的婚姻中,男性因素约占不孕症的40-50%。约30%求医的不育男性患有少精子症或病因不明的无精子症。在重复辅助生殖技术(ART)项目中,精子发生恢复的机会和精子提取的可能性增加的问题对医生和患者都很重要。目的探讨男性不育症患者生精上皮形态学变化与ART成功预后的关系。患者和方法。对264名男性不育症患者进行了检查。所有患者的临床研究范围包括:病史、检查、血激素测定、射精研究、核型、超声。我们根据病人的症状对他的睾丸进行了活检。对睾丸组织进行形态学检查。原发不育症172例(65.2%),继发不育症92例(34.8%)。严重不孕症112例(42.4%)。这些男性的形态学研究结果显示精子发生有不同程度的破坏。在此基础上,提出了一种男性不育症患者的诊断算法,该算法可以在考虑睾丸形态变化的情况下预测ART的成功。在对特定患者精子发生特征的临床和形态学研究的基础上,可以制定进一步的个人诊断和治疗措施计划。
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Prediction of success in assisted reproductive technology with the help of morphology of the testis
In the structure of infertile marriage male factor of infertility occurs in about 40-50%. About 30% of infertile men who have sought medical care have oligozoospermia or azoospermia of unknown etiology. The question of the chances of spermatogenesis recovery and increased probability of sperm extraction in repeated assisted reproductive technology (ART) programs is important for both the doctor and the patient.Purpose. To evaluate the morphological changes of spermatogenic epithelium in patients with male infertility in terms of prognosis of ART success.Patients and methods. 264 men with infertility were examined. The scope of clinical study of all patients included: history, examination, determination of blood hormones, study of ejaculate, karyotype, ultrasound. We performed a biopsy of the testis according to the patient's symptoms. Testicular tissue was subjected to morphological examination.Results. Primary infertility was observed in 172 men (65.2%), secondary — 92 (34.8%). 112 (42.4%) patients had severe infertility. The results of morphological studies in these men showed a different degree of violation of spermatogenesis. Based on the study, a diagnostic algorithm of patients with male infertility is proposed, which allows to predict the success of ART taking into account morphological changes in the testicle.Conclusion. On the basis of clinical and morphological study of the features of spermatogenesis of a particular patient a plan can be made for further personal diagnostic and therapeutic measures.
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