Microdissection TESE versus conventional TESE for men with nonobstructive azoospermia undergoing sperm retrieval

Esteves, Sandro C.

doi:10.1590/s1677-5538.ibju.2022.99.14

Cited by 8 publications

(3 citation statements)

References 32 publications

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“…In conventional TESE, the skin and subjacent layers are opened to expose the tunica albuginea, and single or multiple albuginea openings are made to extract fragments of testicular parenchyma without microsurgery 7 . Microdissection testicular sperm extraction (micro‐TESE) involves testis delivery and tunica albuginea incision 90 . The testicular parenchyma is exposed, and dissection is carried out using an operating microscope to search for enlarged seminiferous tubules more likely to contain mature spermatozoa.…”

Section: Testicular Sperm Retrieval Techniquesmentioning

confidence: 99%

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Surgically retrieved spermatozoa for ICSI cycles in non‐azoospermic males with high sperm DNA fragmentation in semen

2023

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Intracytoplasmic sperm injection (ICSI) using surgically retrieved spermatozoa outside the classic context of azoospermia has been increasingly used to overcome infertility. The primary indications include high levels of sperm DNA damage in ejaculated spermatozoa and severe oligozoospermia or cryptozoospermia, particularly in couples with ICSI failure for no apparent reason. Current evidence suggests that surgically retrieved spermatozoa for ICSI in the above context improves outcomes, mainly concerning pregnancy and miscarriage rates. The reasons are not fully understood but may be related to the lower levels of DNA damage in spermatozoa retrieved from the testis compared with ejaculated counterparts. These findings are consistent with the notion that excessive sperm DNA damage can be a limiting factor responsible for the failure to conceive. Using testicular in preference of low‐quality ejaculated spermatozoa bypasses post‐testicular sperm DNA damage caused primarily by oxidative stress, thus increasing the likelihood of oocyte fertilization by genomically intact spermatozoa. Despite the overall favorable results, data remain limited, and mainly concern males with confirmed sperm DNA damage in the ejaculate. Additionally, information regarding the health of ICSI offspring resulting from the use of surgically retrieved spermatoa of non‐azoospermic males is still lacking. Efforts should be made to improve the male partner's reproductive health for safer ICSI utilization. A comprehensive andrological evaluation aiming to identify and treat the underlying male infertility factor contributing to sperm DNA damage is essential for achieving this goal.

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Section: Testicular Sperm Retrieval Techniquesmentioning

confidence: 99%

“…7 Microdissection testicular sperm extraction (micro-TESE) involves testis delivery and tunica albuginea incision. 90 The testicular parenchyma is exposed, and dissection is carried out using an operating microscope to search for enlarged seminiferous tubules more likely to contain mature spermatozoa.…”

Section: Testicular Sperm Retrieval Techniquesmentioning

confidence: 99%

Surgically retrieved spermatozoa for ICSI cycles in non‐azoospermic males with high sperm DNA fragmentation in semen

2023

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“…Nevertheless, the debate persists on whether mTESE has superior sperm retrieval rates (SRR) compared to cTESE, with diverse ndings reported in the literature on this matter. (3). Still, there is a tendency among andrologists to prefer mTESE if possible if the choice is to be made between the two procedures.…”

Section: Introductionmentioning

confidence: 99%

The effect of discordance between embryologist and pathologist on sperm retrieval rates in patients with non-obstructive azoospermia undergoing mTESE

Sahin,

CAN,

Keskin

et al. 2023

Preprint

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This study investigates predictive factors, specifically the consistency between embryologist and pathologist, influencing sperm retrieval rates in microdissection testicular sperm extraction for non-obstructive azoospermia. The research involved 91 patients aged 20 to 47, who applied to our Reproductive Technology center from July 2020 to June 2023. Patient data, including demographics, physical exams, lab tests, radiological assessments, genetic analyses, medical histories, and histopathological results, were retrospectively collected. Different than literature findings, cases were identified where histopathology showed spermatozoa, yet microdissection testicular sperm extraction yielded unsuccessful sperm retrieval. The Johnsen score was categorized into three groups: spermatozoa found (Group I), maturation arrest (Group II), and no spermatogenesis (Group III). In Group I, despite pathologist-identified spermatozoa, only 66.6% were deemed successful sperm retrieval by the embryologist. Overall sperm retrieval rates were lower than expected at 39.56%. A logistic regression model was employed to determine the independent predictors of positive sperm retrieval. In this analysis, FSH levels, testicular volume, histopathological findings, and alcohol consumption emerged as significant predictive factors for the outcome of sperm retrieval. As a result, in addition to these patient-related factors, the consistency between the pathologist and histologist is also important.

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Male infertility and gonadotropin treatment: What can we learn from real-world data?

Esteves¹,

Achermann²,

Simoni³

et al. 2023

Best Practice & Research Clinical Obstetrics & Gynaecol

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Microdissection TESE versus conventional TESE for men with nonobstructive azoospermia undergoing sperm retrieval

Cited by 8 publications

References 32 publications

Surgically retrieved spermatozoa for ICSI cycles in non‐azoospermic males with high sperm DNA fragmentation in semen

Surgically retrieved spermatozoa for ICSI cycles in non‐azoospermic males with high sperm DNA fragmentation in semen

The effect of discordance between embryologist and pathologist on sperm retrieval rates in patients with non-obstructive azoospermia undergoing mTESE

Male infertility and gonadotropin treatment: What can we learn from real-world data?

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