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  • Azoospermie et Cryoconservation de Spermatozoïdes
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Intérêt de l’autoconservation de spermatozoïdes testiculaires en cas d’azoospermie avant castration sur testicule unique

Testicular sperm extraction before orchiectomy of a solitary testis in patients with azoospermia: A case report

Resume

Nous rapportons la prise en charge, dans un contexte d’urgence oncologique, de deux patients adressés pour autoconservation de gamètes avant castration sur testicule unique, pour lesquels une azoospermie a été découverte le jour de l’autoconservation.

Dans les deux cas, des biopsies testiculaires ont été réalisées de façon synchrone à l’orchidectomie et ont permis la congélation de spermatozoïdes. Une étude anatomo-pathologique de la pièce tumorale et une analyse de la spermatogenèse pour les biopsies en zone saine ont été réalisées. Un bilan génétique (caryotype, recherche des microdélétions du chromosome Y) a été effectué.

Après la fin du traitement oncologique, une TESE (testicular sperm extraction) ICSI (intracytoplasmic sperm injection) a été effectuée pour l’un des couples. Une grossesse gémellaire a été obtenue, un garçon et une fille sont nés en bonne santé.

Ces deux observations d’azoospermie de découverte fortuite dans le cadre d’une indication d’autoconservation de gamètes avant castration pour cancer sur testicule unique, soulignent l’importance de proposer la réalisation de biopsies testiculaires synchrones le jour de l’orchidectomie.

Abstract

Two male patients were urgently referred for gamete cryopreservation before orchiectomy for cancer in a solitary testis (previous history of orchiectomy for torsion of the contralateral spermatic cord), with azoospermia before any sterilizing treatment.

In both cases, testicular sperm extraction was performed at the same time as orchiectomy, allowing the cryopreservation of testicular spermatozoa. Karyotypes were normal and no Y microdeletion or gr/gr deletion was detected.

In one case, one year after the end of treatment, a straw was thawed and testicular spermatozoa were successfully used in a cryoTESE ICSI procedure. A twin pregnancy was obtained and a healthy boy and girl were born.

Testicular sperm extraction and cryopreservation should be proposed to all patients with cancer in a solitary testis and azoospermia.

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Correspondence to Rachel Levy.

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Descombe, L., Huss, M., Aknin, I. et al. Intérêt de l’autoconservation de spermatozoïdes testiculaires en cas d’azoospermie avant castration sur testicule unique. Androl. 17, 134–139 (2007). https://doi.org/10.1007/BF03041167

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  • DOI: https://doi.org/10.1007/BF03041167

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