生精细胞形态学检查联合血清FSH水平检测在NOA患者M-TESE中的应用价值  

Application value of spermatogenic cell morphological examination combined with serum FSH level detection in M-TESE of patients with NOA

作　　者：陈伟辉[1] 陈捷[1] 方小武[1] 韦剑洪[1] 蔡昌明 CHEN Weihui;CHEN Jie;FANG Xiaowu;WEI Jianhong;CAI Changming(Reproductive Medical Center,Boai Hospital of Zhongshan,Zhongshan,Guangdong 528403,China)

机构地区：[1]中山市博爱医院生殖医学中心,广东中山528403

出　　处：《检验医学与临床》2022年第23期3242-3245,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨精液生精细胞形态学检查联合血清卵泡刺激素(FSH)水平检测在非梗阻性无精子症(NOA)患者睾丸显微取精术(M-TESE)中的应用价值。方法以2019年10月至2021年10月在该院生殖医学中心接受M-TESE的41例NOA患者为研究对象,采集精液标本进行生精细胞形态学检查和血清FSH水平检测。将精液生精细胞形态学检查检出生精细胞的患者作为阳性组,未检出生精细胞的患者作为阴性组;显微镜下找到成熟精子为M-TESE成功,未找到成熟精子为M-TESE未成功。分析两组患者的血清FSH水平和M-TESE的成功率。结果41例NOA患者中,阳性组18例,占43.9%;阴性组23例,占56.1%。M-TESE成功15例,未成功26例,总成功率为36.6%,其中阳性组M-TESE成功率为66.7%(12/18),阴性组M-TESE成功率为13.0%(3/23),两组的M-TESE成功率比较,差异有统计学意义(P<0.001)。阳性组血清FSH水平为(27.2±14.2)mIU/mL,阴性组为(39.3±15.0)mIU/mL,差异有统计学意义(P=0.012)。结论NOA患者精液生精细胞形态学检查联合血清FSH水平检测对M-TESE成功率有一定的预测作用。Objective To investigate the application value of seminal spermatogenic cell morphological examination combined with serum follicle-stimulating hormone(FSH)level detection in microdissection testicular sperm extraction(M-TESE)in patients with non-obstructive azoospermia(NOA).Methods From October 2019 to October 2021,41 patients with NOA who received M-TESE in the department of reproductive medical center of this hospital were selected as the research subjects,and seminal spermatogenic cell morphological examination and detection of serum FSH level were performed.The patients with spermatogenic cells in seminal spermatogenic cell morphological examination were taken as the positive group,and the patients without spermatogenic cells were taken as the negative group;the mature sperm was found by microscope to be M-TESE successfully,and mature sperm was not found to be M-TESE unsuccessfully.The serum FSH level and the success rate of M-TESE of the two groups were analyzed.Results Among the 41 patients with NOA,18 patients were in the positive group,accounting for 43.9%;23 patients in the negative group,accounting for 56.1%.There were 15 successful M-TESE cases and 26 unsuccessful cases,with an overall success rate of 36.6%,of which the success rate of M-TESE in the positive group was 66.7%(12/18),and the success rate of M-TESE in the negative group was 13.0%(3/23).Comparison of the success rate of M-TESE between the two groups,the difference was statistical significance(P<0.001).The serum FSH level in positive group was(27.2±14.2)mIU/mL,and that in negative group was(39.3±15.0)mIU/mL,the difference was statistical significance(P=0.012).Conclusion Seminal spermatogenic cell morphological examination combined with serum FSH level detection in patients with NOA has a certain predictive effect on the success rate of M-TESE.

关 键 词：非梗阻性无精子症 生精细胞 睾丸显微取精术 卵泡刺激素 

分 类 号：R698.2[医药卫生—泌尿科学]