Androgen Decline in Patients with Nonobstructive Azoospemia After Microdissection Testicular Sperm Extraction

Takada, Shingo; Tsujimura, Akira; Ueda, Tomohiro; Matsuoka, Yoshikazu; Takao, Tetsuya; Miyagawa, Yasushi; Koga, Minoru; Takeyama, Masami; Okamoto, Yasuaki; Matsumiya, Kiyomi; Fujioka, Hideki; Nonomura, Norio; Okuyama, Äkïhïko

doi:10.1016/j.urology.2008.02.022

Cited by 81 publications

(63 citation statements)

References 21 publications

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“…Similar results have been reported in studies on patients with nonmosaic KS. Okada et al (88) reported a decrease in serum testosterone concentration which did not improve after 12 months, whereas a recovery in serum testosterone to 50% of baseline after 12 months was reported in another study (89). Similar results have been published by Ishikawa et al (90).…”

Section: Complications To Micro-tesesupporting

confidence: 72%

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Aksglæde

Juul

2013

European Journal of Endocrinology

169

114

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Klinefelter syndrome, 47,XXY (KS), is the most frequent sex chromosome aberration in males, affecting 1 in 660 newborn boys. The syndrome is characterized by testicular destruction with extensive fibrosis and hyalinization of the seminiferous tubules resulting in small testes, hypergonadotropic hypogonadism, and azoospermia in the majority of cases. Until recently, infertility was considered an untreatable condition in KS. However, with the development of new advanced assisted reproductive techniques such as testicular sperm extraction (TESE) combined with ICSI it seems that KS patients should no longer be labelled as infertile. Especially, microdissection (micro)-TESE has proved to be an advantageous procedure for the identification of testicular spermatozoa in KS. The aim of this review was to describe current knowledge on the testicular changes occurring in KS, the associated changes in reproductive hormones and spermatogenesis, and the existing possibilities of biological fatherhood in 47,XXY patients. European Journal of Endocrinology 168 R67-R76

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Section: Complications To Micro-tesesupporting

confidence: 72%

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Aksglæde

Juul

2013

European Journal of Endocrinology

169

114

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“…Although some studies have claimed that serum testosterone levels demonstrate no relationship to sperm concentration or testicular biopsy (Jackaman et al, 1977;Goulis et al, 2008), others suggest that testosterone may assume a critical role in both morphological development and reproductive function in the male (Holdcraft and Braun, 2004;Takada et al, 2008). Treatment with exogenous testosterone has been shown to fully rescue spermatogenesis in LH-R knockout mice (Lei et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Seminal Estradiol and Testosterone Levels as Predictors of Human Spermatogenesis

Zhang

Bai

Yang

et al. 2010

Journal of Andrology

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ABSTRACT:The proposed hypothesis for this study was that seminal testosterone/estradiol levels and/or their ratios may be a good indicator for predicting normal spermatogenesis. The concentrations of estradiol and testosterone in seminal fluid were measured using competitive immunoassay techniques in specimens collected from 192 infertile patients and 103 normospermic men. Infertile patients were subdivided into three groups according to their semen analysis results and testicular biopsy: oligozoospermia, obstructive azoospermia (OA), and nonobstructive azoospermia (NOA). Results showed that seminal testosterone levels in the infertile groups were lower than in the normospermic individuals (P , .01), whereas seminal estradiol levels in the OA group were significantly higher than those in normospermic and NOA groups (P , .01). Testosterone/estradiol ratios in the seminal plasma from the infertile groups were significantly lower than that in the normospermic group (P , .01). However, seminal estradiol levels among normospermic and NOA groups showed no significant differences. These results suggest that the local balance between androgen and estrogen, or their ratios, may play an important role in maintaining normal spermatogenesis. Also, decreased seminal testosterone/estradiol ratio may be a good indicator for identifying the absence of sperm production in NOA patients.

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“…The complications of multiple open biopsies (including microdissection TESE) are hematomas, infection, hypogonadism and devascularization of the testis resulting in testicular atrophy. 4,5,15,35,36 In a study by Schlegel and Su, 5 64 patients were evaluated by ultrasound after TESE procedures. At 3 months, 82% of patients had intratesticular abnormalities on ultrasound that were suggestive of persistent hematoma or inflam- Testicular 'mapping' in men with non-obstructive azoospermia ME Beliveau and PJ Turek 228 mation or both.…”

Section: Sperm Detection By Fna Mappingmentioning

confidence: 99%

“…5 It has also been reported that fewer testicular biopsies in TESE procedures result in a less pronounced postoperative testosterone decrease. 36 The increased precision of tissue dissection offered with microTESE is also associated with measurable effects on androgen balance in many hands. 35,36,39 In a study by Takada et al, 36 69 patients were followed after microdissection TESE.…”

Section: Sperm Detection By Fna Mappingmentioning

confidence: 99%

“…36 The increased precision of tissue dissection offered with microTESE is also associated with measurable effects on androgen balance in many hands. 35,36,39 In a study by Takada et al, 36 69 patients were followed after microdissection TESE. Serum testosterone concentrations recovered to only 50-84% of preoperative levels after 1 year in patients with various causes of non-obstructive azoospermia.…”

Section: Sperm Detection By Fna Mappingmentioning

confidence: 99%

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The value of testicular ‘mapping’ in men with non-obstructive azoospermia

Beliveau¹,

Turek²

2011

Asian J Androl

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As the field of assisted reproduction has advanced, many previously untreatable men are now biological fathers. Although finding sperm in men with obstructive azoospermia is not difficult, locating and retrieving spermatozoa in men with non-obstructive azoospermia remains a clinical challenge, largely because sperm production in these men can be patchy or focal in nature. In response to this challenge, strategies such as fine-needle aspiration (FNA) mapping have been developed to find spermatozoa. This review discusses the history, evolution and current clinical utility and findings with FNA mapping for male infertility). Review of the current literature in the English language on FNA (diagnostic or therapeutic) with a keyword focuses on sperm detection, retrieval, safety and complications. FNA was described in human medicine over 100 years ago. Testis FNA was described 45 years ago and FNA 'mapping' of spermatozoa was described in 1997. This comparative review of the literature on sperm detection and complication rates with FNA and open testis biopsy or microdissection procedures suggests that FNA is highly informative, minimally invasive and is associated with fewer complications than other commonly used approaches to sperm detection in non-obstructive azoospermic patients. FNA mapping has gained considerable traction as an informative, 'testis sparing' technique for sperm detection in non-obstructive azoospermia. With knowledge of sperm presence and location prior to sperm retrieval, FNA maps can help clinicians tailor sperm retrieval to optimize time, effort and extent of procedures needed to procure spermatozoa in these difficult cases.

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Androgen Decline in Patients with Nonobstructive Azoospemia After Microdissection Testicular Sperm Extraction

Cited by 81 publications

References 21 publications

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Therapy of endocrine disease: Testicular function and fertility in men with Klinefelter syndrome: a review

Assessment of Seminal Estradiol and Testosterone Levels as Predictors of Human Spermatogenesis

The value of testicular ‘mapping’ in men with non-obstructive azoospermia

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