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대한생식의학회지 제21권 제3호 2010년
폐쇄성 정로장애로 인한 무정자증 환자에서 미세수술적 부고환 정자흡입술과 세포질내 정자주입술을 이용한 수정율 및 임신율 증진에 관한 연구
제일병원 산부인과 불임크리닉;제일병원 비뇨기과;제일병원 비뇨기과;제일병원 체외수정연구실;제일병원 체외수정연구실;제일병원 체외수정연구실;제일병원 산부인과 불임크리닉;제일병원 산부인과 불임크리닉;
손일표;홍재엽;이유식;전진현;박용석;이호준;강인수;전종영;,
Efficacy of Microsurgical Epididymal Sperm Aspiration(MESA) and Intracytoplasmic Sperm Injection(ICSI) in Obstructive Azoospermia
Son, I.P.;Hong, J.Y.;Lee, Y.S.;Jun, J.H.;Park, Y.S.;Lee, H.J.;Kang, I.S.;Jun, J.Y.;
Department of Obstetrics and Gynecology, Cheil General Hospital;Department of Urology, Cheil General Hospital;Department of Urology, Cheil General Hospital;Infertility Research Laboratory, Cheil General Hospital;Infertility Research Laboratory, Cheil General Hospital;Infertility Research Laboratory, Cheil General Hospital;Department of Obstetrics and Gynecology, Cheil General Hospital;Department of Obstetrics and Gynecology, Cheil General Hospital;
We studied the role of assisted fertilization(subzonal insemination, intracytoplasmic sperm injection) in enhancing fertilization and pregnancy rate in obstructive azoospermia. MESA was performed in the patients with congenital absence of the vas deferens and unreconstructable obstructive azoospermia. Sperm were aspirated microsurgically from various sites along the epididymal stump. Sperm were then washed on a mini-PercoH gradient or swim-up method and treated by 2-deoxyadenosine and pentoxifylline. Conventional IVF(group I, 14 cycles), SUZI(group II, 13 cycles) and ICSI(gruop III, 28 cycles) were carried out in 55 treatment cycles. The clinical results are as follows: 1. Fertilization rates for group I, II and III were 16.1 %,31.4% and 48.6%, retrospectively (p<0.05). 2. Clinical pregnancy rates for group I, II and III were 7.1 %,7.7%, and 32.1 'Yo, retrospectively. 3. In 5 of MESA-ICSI cycles, epididymal sperm from alloplastic spermatocele were used and 2 clinical pregnancies (40%) were obtained. According to our results the combined MESA-ICSI procedure is highly effcient in improving fertilization and pregnancy rate in congenital absence of the vas deferens and unreconstructable obstructive azoospermia.
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