Optimization of an approach to solving the problem of a barren marriage in secretory azoospermic men


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AIM: To compare the efficiency of using different interventional procedures for a barren marriage in case of secretory azoospermia (SAS)/MATERIAL AND METHODS: The trial enrolled 110 patients aged 25 to 54 years with SAS. The levels of sexual hormones were determined; ovarian punch biopsy was performed/RESULTS: Decreased volume of the ovaries was noted in 85.3% of the patients; diffuse or focal changes in their parenchyma were seen in 65.7%. There was an increase of follicle-stimulating hormone levels and a reduction in testosterone ones. Hyperestrogenemia was identified in 26.5% of the patients. The level of inhibin B was lower in all the patients. The efficiency of standard testicular sperm extraction for cryopreservation was achieved in 28.7% of the patients and that of a microsurgical technique was in 56.7%. The wives of 37 out of the 57 patients included in an assisted reproductive technology program were more than 12 weeks pregnant after 95 intracytoplasmic sperm injection cycles/CONCLUSION: The microsurgical technique is most effective in achieving the successful treatment of patients with azoospermia in order to prevent male infertility.

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Оптимизация подхода к решению проблемы бесплодного брака у мужчин с секреторной азооспермией. - Резюме. Цель исследования. Сравнить эффективность применения различных методик вмешательства при бесплодном браке в случае секреторной азооспермии (САС). Материалы и методы. В исследование включили 110 больных с САС в возрасте 25-54 лет. Определяли уровни половых гормонов, производили пункционную биопсию яичек. Результаты. У 85,3% пациентов отмечено уменьшение объема яичек, у 65,7% выявлены диффузные или очаговые изменения их паренхимы, повышение уровня фолликулостимулирующего гормона и снижение уровня тестостерона. У 26,5% больных выявлена гиперэстрогенемия. Уровень ингибина В снижен у всех. Эффективность стандартной экстракции сперматозоидов из тканей яичек для криоконсервации достигнута у 28,7% пациентов, при использовании микрохирургического метода - у 56,7%. Супруги 37 из 57 пациентов, включенных в программу вспомогательных репродуктивных технологий, имели беременность в сроки более 12 нед после выполнения 95 циклов интраплазматической инъекции сперматозоидов. Заключение. Микрохирургический метод наиболее эффективен для достижения успеха при лечении больных с азооспермией с целью преодоления мужского бесплодия.
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