Usporedba različitih metoda izolacije spermija iz biopsije sjemenika

master's thesis

• Title (english): Comparison of testicular sperm extraction methods
• Author: Laura Plešnar
• Mentor: Davor Ježek (mentor)
• Committee member: Tvrtko Hudolin (predsjednik povjerenstva)
• Committee member: Dinko Mitrečić (član povjerenstva)
• Committee member: Davor Ježek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Histology and Embryology); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Cytology, Histology and Embryology

Abstract

Neopstruktivna azoospermija je heterogena skupina bolesti kojima je etiologija oštećena spermatogeneza u sjemenicima. NOA je odgovorna za oko 15% muške neplodnosti. Uvođenjem kirurške izolacije spermija iz sjemenika muškarcima s NOA je omogućeno potomstvo. Trudnoća u tih parova se ostvaruje kombinacijom metoda medicinski pomognute oplodnje in vitro (IVF), tj. izolacijom spermija iz sjemenika (TESE) i intracitoplazmatske injekcije tih spermija u jajnu stanicu (ICSI). Izolacija spermija iz sjemenika se može izvesti perkutano iglom (TFNA) ili otvorenim kirurškim pristupom. TFNA se danas koristi kao dodatna tehnika za mapiranje očuvane spermatogeneze u sjemenicima prije otvorene kirurške biopsije. Otvorena biopsija može biti ostvarena s mikroskopskim povećanjem (mTESE) ili bez optičkog aparata (cTESE). Komplikacije nakon zahvata su rijetke te uključuju intratestikularne hematome, pad razine testosterona i narušavanje građe i funkcije testisa s posljedičnom atrofijom tkiva sjemenika. Današnjim zlatnim standardom u izolaciji spermija se smatra mTESE. Mnoge su studije ukazale njenu prednost u uspješnosti izolacije spermija (SRR) i manjem broju postoperativnih komplikacija. Na uspješnost izolacije spermija potencijalno utječu starost muškaraca, volumen sjemenika i genetska pozadina. Njihove prediktivne vrijednosti nisu jednoznačne te se za sada ne koriste kao pokazatelji uspješnosti izolacije spermija. Iako su prednosti mTESE poznate, potrebna su daljnja, dobro osmišljena istraživanja kako bi se utvrdile stvarne razlike između kirurških tehnika.

Abstract (english)

Non-obstructive azoospermia can be described as a heterogeneous group of diseases whose common etiology is impaired spermatogenesis in the testicles. NOA is responsible for about 15% of male infertility. The development of surgical isolation of sperm from the testicles has made it possible for men with NOA to have children. Pregnancy in these couples is achieved through a combination of in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and isolated sperm. Extraction of sperm from the scrotum can be performed percutaneously with a needle (TFNA) or through an open surgical approach. TFNA is now used as an additional technique to map preserved spermatogenesis in the testes before the open surgical biopsy. An open biopsy can be performed with the help of microscopic magnification (mTESE) or without optical apparatus (cTESE). Complications after the procedure are rare and include intratesticular hematomas, a drop in testosterone levels, and impaired testicular integrity with seminal tissue atrophy. Today's gold standard in sperm isolation is mTESE. Many studies have shown its advantage in the success of sperm extraction (SRR) and fewer postoperative complications. The success of sperm isolation can be potentially influenced by men's age, sperm volume, and genetic background. Their predictive values are not unambiguous, and for now, they are not used as indicators of the success of sperm isolation. Although the benefits of mTESE are known, further, well-designed studies are needed to determine the true differences between the surgical techniques.

• Keywords: izolacija spermija; neopstruktivna azoospermija
• Keywords (english): sperm isolation; non-obstructive azoospermia
• Language: croatian
• URN:NBN: urn:nbn:hr:105:793260
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-06 13:01:09