同种异体肾移植术后男性不孕的治疗:一系列病例

D. Takamoto, T. Kawahara, T. Takeshima, Shinnosuke Kuroda, T. Mochizuki, K. Makiyama, Y. Yumura, J. Teranishi, H. Uemura
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引用次数: 2

摘要

肾移植是一种有用的选择,可以让育龄女性肾功能衰竭患者怀孕。然而,关于肾移植对男性肾功能衰竭患者不孕治疗的影响,已有一些报道。我们在此报告两例男性患者在肾移植后接受不孕治疗。病例1:一名51岁的亚洲(日本)男子因常染色体显性多囊肾病(ADPKD)引起的肾衰竭接受了移植(捐赠者是他的妻子)。移植后两年,由于不孕,他去了我们研究所的生殖中心。精液分析显示少弱精子症。他最终没能怀孕,放弃了不孕不育的治疗。病例2:一名47岁的亚洲(日本)男子因糖尿病引起的肾衰竭接受了肾移植(供体是他的妹妹)。肾移植术后三年,他因不孕不育到我们研究所的生殖中心就诊。由于射精障碍和患者手淫后尿液中没有精子,他被诊断为射精。因此,进行了睾丸精子提取(TESE)。用显微TESE(micro-TES)成功取出23个活动精子。随后进行了ICSI,并移植了一个良好的胚胎。他的妻子怀孕了,预计今年十月分娩。我们报告两例肾移植术后男性不育的治疗。
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The Treatment of Male Infertility After Allograft Renal Transplantation: A Case Series
Renal transplantation is a useful option for allowing female renal failure patients of childbearing age to achieve pregnancy. However, there have been a few reports on the effects of renal transplantation on infertility treatment in male renal failure patients. We herein report two cases in which male patients underwent infertility treatment after renal transplantation. Case 1: A 51-year-old Asian (Japanese) man underwent transplantation (the donor was his wife) for renal failure due to Autosomal Dominant Polycystic Kidney Disease (ADPKD). At two years after transplantation, he visited the reproduction center in our institute due to infertility. A semen analysis revealed oligoasthenozoospermia. He ultimately failed to achieve pregnancy and gave up on infertility treatment. Case 2: A 47-year-old Asian (Japanese) man underwent renal transplantation (the donor was his sister) due to renal failure caused by diabetes mellitus. At three years after renal transplantation, he visited the reproduction center in our institute for infertility. Due to ejaculation disability and the absence of sperm in the patient’s urine after masturbation, he was diagnosed with anejaculation. Thus, testicular sperm extraction (TESE) was performed. Twenty-three motile spermatozoa were successfully retrieved by microdissection TESE (micro-TESE). ICSI was subsequently performed and a good embryo was transferred. His wife achieved pregnancy and is expected to deliver this October. We report two cases of male infertility treatment after renal transplantation.
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