睾丸显微取精术结局预测指标的研究进展

The progress on predictive factors of successful microdissection testicular sperm extraction

非梗阻性无精子症(NOA)是指由于睾丸精子发生障碍而导致精液中无精子,但睾丸中可能仍存在多处或孤立的生精灶。由于通过取精手术仍能在睾丸内获取到精子,NOA男性也可以借助ICSI生育自己的生物学后代。不同于传统睾丸取精手术,睾丸显微取精术(M-TESE)借助手术显微镜对睾丸组织进行显微解剖以寻找精子发生灶,大大提高了精子的获取率。虽然M-TESE是NOA患者获取精子的最佳方法,但阳性率不高。目前缺乏更准确的预测指标,因此生精灶的定性和定位诊断具有重要意义。本文旨在对M-TESE结局的预测因素以及未来可能具有应用价值的预测技术进行总结,为NOA的临床诊疗和研究提供参考。

Non-obstructive azoospermia(NOA)results in the absence of sperm in the semen due to a disorder of spermatogenesis in the testes,but multiple or isolated spermatogonial foci may still be present in the testes.Men with NOA may also be able to produce their own biological offspring with the assistance of ICSI,as long as sufficient sperm can be obtained in the testes through sperm retrieval procedures.Unlike traditional testicular sperm retrieval,microdissection testicular sperm extraction(M-TESE)greatly improves sperm retrieval by using a surgical microscope to microscopically dissect the testicular tissue in search of spermatogonial foci.Although sperm retrieval by microdissection testicular sperm extraction is the best method for NOA patients,the positive rate is not high.At present,there is a lack of more accurate predictive indicators,so the qualitative and localization diagnosis of spermatogenic zone is of great significance.The article is to summarize the predictors of M-TESE outcomes and the prediction techniques that may have application value in the future,in order to provide reference for the clinical diagnosis and treatment of NOA.