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Современные подходы к лечению азооспермии методом микро-ТЕСЕ в программе ЭКО/ИКСИ. Обзор литературы. Часть II

https://doi.org/10.14341/probl201359547-60

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Аннотация

Во второй части обзора, посвященного лечению азооспермии методом микро-ТЕСЕ в программе ЭКО/ИКСИ, рассматриваются вопросы гормональной подготовки пациентов с необструктивной азооспермией (НОА) препаратами ГнРГ, хорионическим и менопаузальными гонадотропинами. Эффективность извлечения сперматозоидов возрастает после использования стимуляции сперматогенеза в течение 6 мес и более. Оценка дополнительных гормональных факторов, таких как ФСГ, АМГ, ингибин-В в сыворотке и семенной плазме, позволяют более точно прогнозировать исход микро-ТЕСЕ. Высокий уровень ФСГ не является противопоказанием для микрохирургического извлечения сперматозоидов у мужчин с НОА. Ни уровень ФСГ, ни объем яичек не связаны с результативностью операции. Молекулярно-генетические маркеры остаточного сперматогенеза - гены ESX1, VASA, CLU могут служить предикторами успешного извлечения сперматозоидов при микро-ТЕСЕ у пациентов с НОА. Рассмотрены преимущества методики микродиссекции, техника выполнения операции, включая эмбриологический этап выделения сперматозоидов из тестикулярной ткани, результативность микро-ТЕСЕ в зависимости от патоморфологической картины и осложнения после операции.

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Для цитирования:


., ., . Современные подходы к лечению азооспермии методом микро-ТЕСЕ в программе ЭКО/ИКСИ. Обзор литературы. Часть II. Проблемы Эндокринологии. 2013;59(5):47-60. https://doi.org/10.14341/probl201359547-60

For citation:


Vitiazeva I.I., Bogoliubov S.V., Dedov I.I. The role of modern technologies in the management of azoospermia using micro-TESE in the framework of the ECF/ICSI program. A literature review. Part II. Problems of Endocrinology. 2013;59(5):47-60. (In Russ.) https://doi.org/10.14341/probl201359547-60

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