トヨタ記念病院における男性不妊症に対するTESE(Testicular sperm extraction)の臨床成績

Abstract

著者らの施設における男性不妊症に対する精巣内精子採取法(TESE)の臨床成績について検討した.対象は, 男性不妊症でTESEを施行した30例(平均年齢35.0歳)で, 内訳は閉塞性無精子症7例(精管, 射精管閉塞4例, 精管切断術後3例), 非閉塞性無精子症21例(染色体異常1例, 原因不明20例), 射精障害(脊髄損傷)2例であった.30例中20例で精子回収が可能であったが, 1例は不動精子で凍結保存はできなかった.20例中15例にICSI(卵細胞質内精子注入法)を施行し, 8例で妊娠が成立, 7例で出産に成功した.非閉塞性無精子症21例中精子回収可能であった11例(52%)と不可能であった10例における精子回収の予測因子の検討では, FSH・LHは非回収群で有意に高値であり, Johnsen's scoreは非回収群で有意に低かった.この3因子は精子回収の予測因子となり得ると考えられた

Owing to progress of assisted reproduction technology in recent years, it has become possible for couples with infertility problems to have children. Between March 1998 and May 2003 testicular sperm extraction (TESE) was performed on 30 men with male-factor infertility in our hospital. Consequently, we succeeded in recovering 20 spermatozoa. Intracytoplasmic sperm injection was subsequently performed in 15 couples and resulted in 8 pregnancies. There was a statistically significant difference in follicle-stimulating hormone, luteirizing hormone and Johnsen's score between the non-obstructive groups with successful TESE and those with unsuccessful TESE.