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대한생식의학회지 제24권 제1호 2010년
비폐쇄성 무정자증의 치료
삼성제일병원 비뇨기과;삼성제일병원 불임연구실;삼성제일병원 비뇨기과;삼성제일병원 비뇨기과;삼성제일병원 불임연구실;삼성제일병원 불임연구실;삼성제일병원 산부인과;삼성제일병원 산부인과;삼성제일병원 산부인과;
서주태;박용석;김종현;이유식;전진현;이호준;손일표;강인수;전종영;,
The treatment of Non-obstructive Azoospermia
Seo, Ju-Tae;Park, Yong-Seog;Kim, Jong-Hyun;Lee, You-Sik;Jun, Jin-Hyun;Lee, Ho-Joon;Son, Il-Pyo;Kang, Inn-Soo;Jun, Jong-Young;
Department of Urology, Samsung Cheil Hospital & Women's Healthcare Center;Infertility Research Laboratory, Samsung Cheil Hospital & Women's Healthcare Center;Department of Urology, Samsung Cheil Hospital & Women's Healthcare Center;Department of Urology, Samsung Cheil Hospital & Women's Healthcare Center;Infertility Research Laboratory, Samsung Cheil Hospital & Women's Healthcare Center;Infertility Research Laboratory, Samsung Cheil Hospital & Women's Healthcare Center;Department of Obstetrics and Gynecology, Samsung Cheil Hospital & Women's Healthcare Center;Department of Obstetrics and Gynecology, Samsung Cheil Hospital & Women's Healthcare Center;Department of Obstetrics and Gynecology, Samsung Cheil Hospital & Women's Healthcare Center;
Irreparable obstructive azoospermic patients can be treated successfully with microsurgical epididymal sperm aspiration(MESA) or testicular sperm extraction (TESE) by intracytoplasmic sperm injection(ICSI). Obstructive azoospermic patients generally have normal spermatogenesis. The aim of this study was to see if any spermatozoa could be retrieved from non-obstructive azoospermia and to assess the efficacy of ICSI with TESE in germinal failure. 42 non-obstructive azoospermic patients revealed no spermatozoa at all in their ejaculates, even after centrifuge. The histology of 42 patients revealed 15 Sertoli cell only Syndrome, 4 maturation arrest and 23 severe hypospermatogenesis. All patients underwent extensive multiple testicular biopsy for sperm retrieval. These patients were scheduled for ICSI using testicular spermatozoa. In 25 out of 42 non-obstructive azoospermic patients, spermatozoa were recovered from multiple testicular biopsy specimen and 11 ongoing pregnancies were achieved. There are usually some tiny foci of spermatogenesis which allow TESE with ICSI in non-obstructive azoospermia. Also these patients may have sufficient sperm in the testes for ICSI, despite extremely high FSH level and small testes.
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