Modification of the techniques for better testicular sperm retrieval in repeated Testicular Sperm Extraction (TESE) and following Intracytoplasmic Sperm Injection (ICSI) &ndash
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(3) (ICSI)— Modification of the techniques for better testicular sperm retrieval in repeated Testicular Sperm Extraction (TESE) and following Intracytoplasmic Sperm Injection (ICSI) – Evaluation of Clinical Trial and Animal experiment !"#NSC 87-2314-B-038-046 $ %V ' 8 ( 1 )* 87 ' 7 ( 31 ) +,-#./0 12345 678 . screening biopsy method. Clinically, the specimen of seminiferous tubules from the non-obstructive azoospermia patients can be screened with Fluorescence In Situ Hybridization (FISH). If there existed a halploid chromosome showed in FISH, that means meiosis did have been happened in the seminiferous tubule, then further testicular sperm extraction (TESE) for the ICSI will be performed. Recently, we do microdissection of seminiferous tubules in the procedure of TESE. Under microscope, we can differentiate the healthy seminiferous tubule from fibrotic one, and dissected for TESE. In the experience of sperm frozen, our result revealed that Yolk Buffer is the best medium to reserve sperm motility after defrozen. Based on our experience, modification of the technique for better testicular sperm retrieval will provide more opportunities in the future for ICSI and less injury to the testicular of the patients with testicular azoospermia..
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(11) >ª ~9. In this project, we focus to evaluate the update technique for testicular sperm extraction and preservation for the infertile male who are needed for repeated sperm retrieval in the cycle of Intracytoplasmic Sperm Injection (ICSI). Through the result of the rabbit experiment, we found that open, fine needle, multi-direction aspiration to get seminiferous tubule is minimal invasive and the most informative. $W!" 1. «¬ ®o[.
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(26) _ ûüþ¦õ Yolk buffer Àò=uÅ{ Yolk buffer tS ` aD4 tu 4 IV.bwq(Ý*+,-cé III. x p.ïBH d¦eÛ MN ¾¿k¬ aÛ ¢£ f_a8à gh4"1%&'RSh ®"1%rsM! CDE*+ Ö*+a µ>cMN*+ FRS öNWH ¾¿B ,-4"2%&'9H *+ K¥ Hµ"2%o[(Microdissection) ¦ µ>i"3%&'()9aj *+ B*+ TF: Xµ Z_ ÛDE4Y?ú "3%> FISH /*+aL ? RSÃÄê 1>6789 : pk]_åM
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(28) ïB龿 ÀÁlmno½. >pÛ7 3.5 q @çYJ>/ 6Êé¹Â À rsM!?ú46 GH z é $W.º I &xa UVWL X%J 4 YJ>t'/ ICSI TUVWL X %uhvÊí Cycle / GHI . ÃÄ IJ *+?úp!K*+ýM. . o[? ¥¦aj / ICSIµ&x RS FqL Þß>ZÖ,. \2^!! Palermo,. G., Joris, H., Devroey, P.: Pregnancies after intracytoplasmic injection of a single. 3.
(29) spermatozoa into an oocyte. Lancet, 340:17-18,1992. \3^!! Tournaye, H., Devroey, P., Liu, J. : Microsuegical epididymal sperm aspiration and intracytoplasmic sperm injection : a now effective approach to infertility as a result of congenital bilateral absence of vas deferens. Fertil. Steril.,61:1045-1051,1994. \4^!! Silber, S. J., Van Steirteghem, A. C., Liu, J. : High fertilization and pregnancy rate after sperm injection with spermatozoa obtained from testicle biopsy. Hum. Reprod.,10:148-152,1995. \5^!! Chiang, H. S. : Clinical study of vasectomy reversal :results of 60 single-surgeon cases in Taiwan. J. Formos. Med. Assoc.,95(11):866-869,1996. \6^!! Wang, Y.H., Chiang, H. S., Wu, C. C., and Lien, Y. N. : Electroejaculation in spinal cord injured males. J. Formosan. Med. Assoc.,91(4):413-418,1992. \7^!! Chiang, H. S., Wu. C. C., Chen, K. C., Wand, D, Chen, H. M., and Tzeng, C. C. : Functional characteristics of sperm obtained by microsurgical epididymal aspiration. Mol Androl 6:5-14,1994. \8^!! Chiang, H. S., Liu, C. H.: Intracytoplasmic sperm injection in male infertility.J Urol. ROC. 8(4):1-7,1997. \9^!! Chiang, H. S., Liu, C. H., and Fang C. L. : Surgical and pathological observation of epididymal tubule in the microscopic epididymal sperm aspiration (MESA) for intracytoplasmic sperm injection (ICSI).J Fromosan Med. Assoc.97(12),1998(in press) \:^!! Madgar, I., Hourvitz, A., Levron, J.,Seidman, D.S., Shulman, A., Raviv, G.G., Levran, D., and Bider, D. : Outcome of in vitro fertilization and intracytoplasmic injection of epididymal and testicular sperm extracted from patients with obstructive and nonobstructive azoospermia. Fertility & Sterility. 69(6):1080-4,1998. \21^!!Friedler, S., Raziel, A., Soffer, Y., Strassburger, D., Komarovsky, D. and Ron-el, R. : Intracytoplasmic injection of fresh and cryopreserved testicular spermatozoa in patients with nonobstructive azoospermia – a comparative study. Fertility & Sterility. 68(5):892-7,1997. \22^!!Mulhall, J.P., Burgess, C.M., Cunningham, D., Carson, R., Harris, D. and Oates, R.D. : Presence of mature sperm in testicular parenchyma of men with nonobstructive azoospermia: prevalence and predictive factors. Urology. 49(1):91-5; discussion 95-6,1997. \23^!!Schlegel, P.N., Palermo, G.D., Goldstein, M., Menendez, S., Zaninovic, N. and Veeck, L.L. Rosenwaks, Z. : Testicular sperm extraction with intracytoplasmic sperm injection for. nonobstructive azoospermia. 49(3):435-40,1997.. Urology..
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