{"id":18600,"date":"2020-12-10T18:02:50","date_gmt":"2020-12-10T15:02:50","guid":{"rendered":"https:\/\/medimall.gr\/azoospermia-ivf-i-lysi-stin-andriki-ypogonimotita\/"},"modified":"2022-10-14T15:10:09","modified_gmt":"2022-10-14T12:10:09","slug":"azoospermia-fiv-solutia-pentru-infertilitatea-masculina","status":"publish","type":"post","link":"https:\/\/medimall.gr\/ro\/azoospermia-fiv-solutia-pentru-infertilitatea-masculina\/","title":{"rendered":"Azoospermia: FIV solu\u021bia pentru infertilitatea masculin\u0103"},"content":{"rendered":"

Datorit\u0103 dezvolt\u0103rii medicinei \u0219i a tehnologiei, b\u0103rba\u021bii care sufer\u0103 de azoospermie (absen\u021ba spermatozoizilor \u00een sperm\u0103) pot acum s\u0103 revendice dreptul la paternitate.
\n<\/span><\/h1>\n

Mul\u021bi b\u0103rba\u021bi \u00eencearc\u0103 s\u0103 aib\u0103 un copil \u0219i, \u00een cele din urm\u0103, afl\u0103 c\u0103 produc sperm\u0103 f\u0103r\u0103 sperm\u0103. Aceast\u0103 tulburare se nume\u0219te azoospermie, nu provoac\u0103 simptome specifice, dar este diagnosticat\u0103 atunci c\u00e2nd un b\u0103rbat este supus unei spermograme pentru a evalua num\u0103rul \u0219i calitatea spermatozoizilor.<\/p>\n

Procentul de b\u0103rba\u021bi azoospermi \u00een popula\u021bia general\u0103 este de 1%, \u00een timp ce \u00een cazul cuplurilor infertile care \u00ee\u0219i investigheaz\u0103 fertilitatea, b\u0103rba\u021bii azoospermi reprezint\u0103 p\u00e2n\u0103 la 10%.<\/p>\n

\u00cen trecut, azoospermia era tratat\u0103 doar prin donarea de sperm\u0103, dar acum b\u0103rba\u021bii care sufer\u0103 de aceast\u0103 afec\u021biune au posibilitatea de a-\u0219i ob\u021bine propria descenden\u021b\u0103 biologic\u0103 prin procedura de reproducere asistat\u0103 \u0219i, \u00een special, prin procedura de microfertilizare.<\/p>\n

Care este cauza azoospermiei?<\/h3>\n

Azoospermia poate fi cauzat\u0103 de o problem\u0103 care fie \u00eempiedic\u0103 producerea de spermatozoizi s\u0103n\u0103to\u0219i \u00een testicule, fie \u00eempiedic\u0103 eliberarea lor din organism. Exist\u0103, de asemenea, unele cazuri de b\u0103rba\u021bi care nu produc deloc sperm\u0103.<\/p>\n

Produc\u021bia de spermatozoizi \u00een testicule poate fi \u00eempiedicat\u0103 de mai multe cauze, cum ar fi:<\/p>\n

    \n
  1. Criptorhidie.<\/li>\n
  2. Infec\u021bii ale tractului reproduc\u0103tor, cum ar fi epididimita sau uretrita.<\/li>\n
  3. Complica\u021bii ale anumitor boli infec\u021bioase virale.<\/li>\n
  4. Leziuni la inghinali.<\/li>\n
  5. Cancerul sau tratamentele acestuia, cum ar fi radioterapia.<\/li>\n
  6. Bolile cromozomiale, cum ar fi sindromul Klinefelter, \u00een care spermatozoizii produ\u0219i sunt minime sau inexistente.<\/li>\n<\/ol>\n

    Diagnosticul<\/h3>\n

    Pentru a diagnostica azoospermia, se face mai \u00eent\u00e2i o spermogram\u0103. Aceasta este cea mai important\u0103 etap\u0103 care necesit\u0103, pe l\u00e2ng\u0103 o examinare atent\u0103, centrifugarea, deoarece \u00een mai multe probe, care sunt ini\u021bial negative pentru prezen\u021ba spermatozoizilor, spermatozoizii sunt \u00een cele din urm\u0103 detecta\u021bi dup\u0103 centrifugarea probei. Dac\u0103 \u00een urma testului nu se g\u0103se\u0219te niciun spermatozoid, atunci proba poate fi clasificat\u0103 ca fiind azoospermic\u0103. \u00cen aceste cazuri, se recomand\u0103 repetarea spermogramei pentru a confirma prima observa\u021bie.<\/p>\n

    \u00cen general, dac\u0103 nu exist\u0103 spermatozoizi la 2-3 spermograme (la distan\u021b\u0103 \u00een timp), pacientul trebuie s\u0103 discute cu medicul s\u0103u posibilitatea unui tratament sau a unei biopsii testiculare. \u00cen majoritatea cazurilor de azoospermie, biopsia testicular\u0103 r\u0103m\u00e2ne singurul test care va ar\u0103ta dac\u0103 exist\u0103 sau nu spermatozoizi \u00een testicule.<\/p>\n

    Tratamentele
    \n<\/span><\/h2>\n

    Biopsia testicular\u0103 (metoda TESE)<\/h3>\n

    Odat\u0103 ce azoospermia a fost stabilit\u0103 \u0219i confirmat\u0103, urmeaz\u0103 o investiga\u021bie atent\u0103 pentru a determina posibilele cauze ale acesteia. \u00cen majoritatea cazurilor, se recomand\u0103 o biopsie testicular\u0103.<\/p>\n

    Pentru toate cazurile de azoospermie (cu excep\u021bia hipogonadismului hipogonadotrofic), biopsia testicular\u0103 r\u0103m\u00e2ne cea mai veche \u0219i cea mai adecvat\u0103 metod\u0103 pentru a determina dac\u0103 \u00een testicule sunt sau nu prezen\u021bi spermatozoizi.<\/p>\n

    \u00cen cazul \u00een care proba testicular\u0103 prelevat\u0103 con\u021bine chiar \u0219i forme imature de spermatozoizi, ace\u0219tia pot fi \u00een multe cazuri izola\u021bi, cultiva\u021bi folosind tehnici speciale pentru a-i maturiza \u0219i apoi utiliza\u021bi pentru FIV prin microfertilizare.<\/p>\n

    \u039c\u03b9\u03ba\u03c1\u03bf\u03b3\u03bf\u03bd\u03b9\u03bc\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7 ICSI \u03ba\u03b1\u03b9 \u0391\u03b6\u03c9\u03bf\u03c3\u03c0\u03b5\u03c1\u03bc\u03af\u03b1<\/h3>\n

    Microfertilizarea ICSI (Injec\u021bia intracitoplasmatic\u0103 de spermatozoizi) este o metod\u0103 de fertilizare in vitro \u00een care un singur spermatozoid este injectat direct \u00een ovul pentru a-l fertiliza.<\/p>\n

    ICSI, sau Injec\u021bia intracitoplasmatic\u0103 de sperm\u0103, a fost practicat\u0103 cu succes \u00een \u00eentreaga lume de la \u00eenceputul anilor 1990 \u0219i este un tratament cu adev\u0103rat eficient pentru ob\u021binerea unei sarcini.<\/p>\n

    Cum se realizeaz\u0103 tehnica ICSI?<\/h3>\n

    Dup\u0103 recoltarea materialului seminal, \u00een func\u021bie de num\u0103rul \u0219i motilitatea spermatozoizilor, se aplic\u0103 un tratament pentru activarea acestora, cu mici modific\u0103ri. \u00cen cazul \u00een care proba de sperm\u0103 nu este suficient\u0103, partenerul este rugat s\u0103 furnizeze o a doua prob\u0103 suplimentar\u0103 c\u00e2teva zile mai t\u00e2rziu. \u00cen cazul \u00een care sperma con\u021bine chiar \u0219i c\u00e2teva zeci de spermatozoizi mobili, microfertilizarea poate fi efectuat\u0103 \u00een mod normal.<\/p>\n

    La fel ca \u0219i FIV conven\u021bional\u0103, procedura de microfertilizare ICSI necesit\u0103 stimularea prealabil\u0103 a ovarelor cu medicamente pentru fertilitate pentru a produce mai multe ovule mature. Dup\u0103 ce ovulele au fost aspirate, acestea sunt supuse unui “tratament” special cu o enzim\u0103 (hialuronidaza) pentru a \u00eendep\u0103rta celulele granuloase din jur. Acest lucru este necesar, altfel spermatozoizii nu vor putea s\u0103 p\u0103trund\u0103, deoarece \u00een ICSI spermatozoizii sunt injecta\u021bi \u0219i nu pe cont propriu, ca \u00een cazul FIV conven\u021bional\u0103. Acest “tratament” dureaz\u0103 1-2 minute \u0219i, odat\u0103 ce ovocitele sunt eliberate de granulocite, este posibil s\u0103 se evalueze care sunt mature \u0219i potrivite pentru ICSI \u0219i care nu.<\/p>\n

    Etapa final\u0103 a procedurii ICSI const\u0103 \u00een imobilizarea fiec\u0103rui ovul \u00een parte cu ajutorul unei pipete fine de sticl\u0103 \u0219i cu o alt\u0103 pipet\u0103 mai fin\u0103 de sticl\u0103 (care seam\u0103n\u0103 cu un ac de injec\u021bie) pentru a izola fiecare spermatozoid care va fi apoi introdus \u00een citoplasma fiec\u0103rui ovul. Fiecare “inser\u021bie” dureaz\u0103 c\u00e2teva secunde, dar \u00eentregul proces poate dura c\u00e2teva ore, mai ales dac\u0103 spermatozoizii sunt pu\u021bini \u0219i greu de g\u0103sit.<\/p>\n

    Odat\u0103 ce procesul de “inser\u021bie” este finalizat, ovulele sunt plasate din nou \u00een medii de cultur\u0103 speciale p\u00e2n\u0103 c\u00e2nd sunt complet fertilizate \u0219i se produc embrioni. Metoda este finalizat\u0103 prin respectarea procedurii bine-cunoscute de fertilizare in vitro: dup\u0103 crearea blastocisturilor, embrionii sunt selecta\u021bi \u0219i, \u00een final, transfera\u021bi.<\/p>\n

    Ratele de succes<\/h3>\n

    Succesul tehnicii ICSI depinde de mai mul\u021bi factori, cum ar fi:<\/h4>\n
      \n
    • viabilitatea spermei<\/li>\n
    • calitatea ovocitelor<\/li>\n
    • calitatea ovocitelor, calitatea calit\u0103\u021bii spermatozoizilor<\/li>\n
    • capacitatea ovocitelor de a rezista la procesul endocitoplasmatic<\/li>\n<\/ul>\n

      Rata de reu\u0219it\u0103 a sarcinii la fiecare \u00eencercare cu tehnica ICSI este de 65-75%. Poten\u021bialii factori care pot influen\u021ba ratele de succes \u00een cursul sarcinii \u0219i, prin urmare, finalizarea na\u0219terii cu microfertilizarea ICSI sunt similare cu cele ale FIV conven\u021bionale.<\/p>\n

      \n
      \n

      “Ast\u0103zi, datorit\u0103 dezvolt\u0103rii rapide din ultimii ani, medicina ofer\u0103 o solu\u021bie chiar \u0219i \u00een cele mai speciale cazuri, at\u00e2ta timp c\u00e2t este identificat\u0103 cauza problemei la sperm\u0103”, spune eminentul chirurg urolog-androlog urolog Vassilis Protogerou, asistent chirurg. Profesor la Facultatea de Medicin\u0103 a Universit\u0103\u021bii din Atena.<\/p>\n

       <\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

      Datorit\u0103 dezvolt\u0103rii medicinei \u0219i a tehnologiei, b\u0103rba\u021bii care sufer\u0103 de azoospermie (absen\u021ba spermatozoizilor \u00een sperm\u0103) pot acum s\u0103 revendice dreptul la paternitate. Mul\u021bi b\u0103rba\u021bi \u00eencearc\u0103 s\u0103 aib\u0103 un copil \u0219i, \u00een cele din urm\u0103, afl\u0103 c\u0103 produc sperm\u0103 f\u0103r\u0103 sperm\u0103. Aceast\u0103 tulburare se nume\u0219te azoospermie, nu provoac\u0103 simptome specifice, dar este diagnosticat\u0103 atunci c\u00e2nd un […]<\/p>\n","protected":false},"author":2,"featured_media":10621,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6],"tags":[2320,2321,2322,2323,2324,2325],"featured_image_src":{"landsacpe":["https:\/\/medimall.gr\/wp-content\/uploads\/2020\/12\/sentindo-se-desanimado-2-1024x683-1-1024x445.jpg",1024,445,true],"list":["https:\/\/medimall.gr\/wp-content\/uploads\/2020\/12\/sentindo-se-desanimado-2-1024x683-1-463x348.jpg",463,348,true],"medium":["https:\/\/medimall.gr\/wp-content\/uploads\/2020\/12\/sentindo-se-desanimado-2-1024x683-1-300x200.jpg",300,200,true],"full":["https:\/\/medimall.gr\/wp-content\/uploads\/2020\/12\/sentindo-se-desanimado-2-1024x683-1.jpg",1024,683,false]},"yoast_head":"\nAzoospermia: FIV solu\u021bia pentru infertilitatea masculin\u0103 - Medimall IVF<\/title>\n<meta name=\"description\" content=\"\u03a4\u03bf \u03b4\u03b9\u03ba\u03b1\u03af\u03c9\u03bc\u03b1 \u03c3\u03c4\u03b7\u03bd \u03c0\u03b1\u03c4\u03c1\u03cc\u03c4\u03b7\u03c4\u03b1 \u03b4\u03b9\u03b5\u03ba\u03b4\u03b9\u03ba\u03bf\u03cd\u03bd \u03c0\u03bb\u03ad\u03bf\u03bd \u03ba\u03b1\u03b9 \u03bf\u03b9 \u03ac\u03bd\u03b4\u03c1\u03b5\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03ac\u03c3\u03c7\u03bf\u03c5\u03bd \u03b1\u03c0\u03cc \u03b1\u03b6\u03c9\u03bf\u03c3\u03c0\u03b5\u03c1\u03bc\u03af\u03b1 (\u03b1\u03c0\u03bf\u03c5\u03c3\u03af\u03b1 \u03c3\u03c0\u03b5\u03c1\u03bc\u03b1\u03c4\u03bf\u03b6\u03c9\u03b1\u03c1\u03af\u03c9\u03bd) \u03c7\u03ac\u03c1\u03b7 \u03c3\u03c4\u03b7\u03bd \u03b5\u03be\u03ad\u03bb\u03b9\u03be\u03b7 \u03c4\u03b7\u03c2 \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae\u03c2.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medimall.gr\/ro\/azoospermia-fiv-solutia-pentru-infertilitatea-masculina\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Azoospermia: FIV solu\u021bia pentru infertilitatea masculin\u0103 - 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