Các kỹ thuật lấy tinh trùng tinh hoàn ở nam giới vô tinh không bế tắc

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Tác giả: Đình Hiếu Lê, Thanh Quang Nguyễn, Nhật Thăng Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.31

Bộ sưu tập: Metadata

ID: 339376

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Sự ra đời của kỹ thuật tiêm tinh trùng vào bào tương trứng (ICSI: intracytoplasmic sperm injection) năm 1992 đã cho phép thụ tinh với tinh trùng lấy từ nam giới vô tinh. Trong vô tinh không bế tắc (NOA: nonobstructive azoospermia), thường khó lấy được tinh trùng do có rất ít hoặc không có tinh trùng trưởng thành và sinh tinh thường khu trú, rải rác trong tinh hoàn. Vì vậy, các kỹ thuật lấy tinh trùng tinh hoàn đã có nhiều cải tiến nhằm tăng tỷ lệ tìm thấy tinh trùng (hiệu quả) và giảm thiểu biến chứng (an toàn) cho bệnh nhân. Phân tích Cochrane y văn không tìm thấy các thử nghiệm ngẫu nhiên đối chứng, làm cơ sở khoa học cho khuyến cáo kỹ thuật này so với kỹ thuật khác vì mỗi kỹ thuật có ưu và khuyết điểm riêng. Khuyến cáo duy nhất là chọn lựa kỹ thuật ít xâm lấn nhất và đơn giản nhất có thể để lấy tinh trùng tinh hoàn. Suy sinh dục nam sau các thủ thuật lấy tinh trùng tinh hoàn có thể ảnh hưởng lâu dài đến sức khỏe nam giới. Các tiến bộ kỹ thuật trong tương lai liên quan đến kỹ thuật lấy tinh trùng tinh hoàn, nhận diện tinh trùng ở phòng lab IVF, và các kỹ thuật mới giúp tăng tỷ lệ tinh trùng sống sau đông và rã đông… chắc chắn sẽ tác động không nhỏ đến khả năng y học giúp nam giới NOA có thể được làm bố sinh học.AbstractThe advent of intracytoplasmic sperm injection (ICSI) in 1992 allows the possibility of conception with sperms retrieved from azoospermic men. In nonobstructive azoospermia (NOA) or testicular failure, it’s often difficult to retrieve sperms due to the presence of few mature sperms and patchy spermatogenesis in the testis. Therefore, the field of testicular sperm retrieval has witnessed tremendous changes to increase sperm retrieval rates (higher sperm yields) and minimize surgical complications (more safety). A Cochrane review of the literature on techniques of testicular sperm retrieval found a lack of randomized controlled trials to recommend any one testicular sperm retrieval technique over another for NOA as each has its strengths and limitations. The only solid recommendation was to select the least invasive and simplest technique for testicular sperm retrieval whenever possible. Hypogonadism after testicular sperm retrieval procedures could have large and durable effects on man health and overall quality of life. Future advances in testicular sperm retrieval procedures, sperm identification in the IVF laboratory, and novel technologies to increase the yield of viable sperm after freezing and thawing... will certainly have major impact on the medical ability to help NOA men to become biological fathers. DOI: 10.59715/pntjmp.1.4.4

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