Clinical comparison between conventional and microdissection testicular sperm extraction for non-obstructive azoospermia: Understanding which treatment works for which patient

Maglia, Elia; Boeri, Luca; Fontana, Matteo; Gallioli, Andrea; Lorenzis, E. De; Palmisano, Franco; Zanetti, S.P.; Sampogna, G.; Restelli, Liliana; Somigliana, Edgardo; Serrago, M.; Gadda, Franco; Montanari, Emanuele

doi:10.4081/aiua.2018.2.130

Cited by 19 publications

(15 citation statements)

References 14 publications

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“…SRRs may serve as points of comparison between different operative techniques, which may help surgeons identify more efficacious approaches, as demonstrated by Bernie et al (2015) 17 . Similarly, highlighting predictors of retrieval of any testicular spermatozoa may help identify specific demographics of NOA patients and specific histopathology which are correlated with higher retrieval, as demonstrated by Maglia et al (2018) 71 . However, there is little published consensus on exactly what defines a successful sperm retrieval.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the quality of reported outcomes for microsurgical TESE in men with non‐obstructive azoospermia: A methodological analysis

et al. 2021

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Background: Publications of microsurgical testicular sperm extraction (mTESE) techniques and outcomes are heterogeneous, which may limit creation of best surgical practices.Objective: To study the quality and heterogeneity of published mTESE outcomes via a methodological analysis. Materials/Methods:A systematic methodological analysis of all published literature on the use of mTESE in men with non-obstructive azoospermia from 1999 to the July 2020 was performed. PubMed and MEDLINE searches were performed using the search terms "microdissection TESE OR microsurgical TESE." Publications were evaluated on their reporting of pre-operative factors, intraoperative techniques, surgical and clinical outcomes, and adverse events.Results: Fifty-five studies met inclusion criteria. Surgical technique and sperm retrieval rates were the most reported criteria. Reporting on the presence of an embryologist intraoperatively was observed in approximately 30% of articles, while other procedural details including method of sperm quantification, quantity retrieved, and number of cryopreserved vials were observed in fewer than 10% of articles. Clinical outcomes, including pregnancy rates and live birth rates, were reported in fewer than 40% of the articles. Fetal outcomes including fetal and neonatal anomalies were rarely reported. Fetal growth restriction, preterm delivery, small or large for gestational age, and NICU admissions were never reported. Conclusion:There are inconsistencies in reporting quality of mTESE outcomes, specifically a lack of information on the quantity and quality of sperm retrieved, the role of embryology intraoperatively, and clinical outcomes, such as live birth rate and fetal anomalies. These gaps may guide development of standardized reporting guidelines to better assess and compare clinical outcomes across institutions and maintain focus on couples-centric fertility outcomes in future mTESE studies.

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Section: Discussionmentioning

confidence: 99%

Evaluating the quality of reported outcomes for microsurgical TESE in men with non‐obstructive azoospermia: A methodological analysis

et al. 2021

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“…However, some studies have shown that there are no precise and noninvasive methods for predicting whether there are testicular spermatozoa in NOA patients before mTESE [ 10 ]. Maglia et al found that the success rate of sperm retrieval in NOA patients was similar between the mTESE group and the conventional TESA group, and mTESE seemed to be more beneficial for patients over 35 years of age and with high FSH value [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Different Testicular Sperm Extraction Methods on the Embryonic Development of Azoospermic Men in Intracytoplasmic Sperm Injection (ICSI) Cycles: A Retrospective Cohort Study

Cao

et al. 2021

BioMed Research International

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Background. The effects of different testicular sperm extraction methods on the embryonic development and clinical outcome of azoospermic men in intracytoplasmic sperm injection (ICSI) cycles have not been researched. Our goal was to evaluate the effect of different sperm retrieval methods used for patients with OA or NOA on the embryonic development and clinical outcomes during the ICSI cycles. Methods. This was a retrospective cohort study. A total of 530 azoospermic patients who underwent 570 ICSI cycles met the study criteria. ICSI was performed using testicular sperm by TESA in 282 cycles (TESA group); ICSI with testicular sperm by mTESE was performed due to NOA in 90 cycles (mTESE group); ICSI with testicular sperm by MESA was performed in 198 cycles (MESA group). The embryonic development and clinical outcomes of the three groups were counted. Results. The general characteristics of the three groups were comparable. Our findings showed that the three groups were matched in terms of infertility durations and age. The mean age and the mean BMI of the female partners were similar in the three groups. Also, our findings showed there were no significant differences in the three groups regarding day 3 of the menstrual cycle FSH and days of stimulation. The research results showed that the total dose of FSH and E2 on the HCG administration day was also not statistically different in the three groups. The number of oocytes retrieved had no significant differences in the three groups. However, the number of 2PNs per cycle and the number of cleavages per cycle were higher in the MESA group than in the other two groups; the TESA group and mTESE group were similar. The number of good quality D3 embryos and the number of good quality D5 embryos were significantly decreased in the mTESE group as compared to the other two groups. Good quality D3 embryos and the rate of good quality D5 embryos in the mTESE group were lower than those in the other two groups. Moreover, the clinical pregnancy rates of the TESA group (50.71%) and the MESA group (51.52%) were similar, but both were much higher than that of the mTESE group (32.22%). Conclusions. The mTESE provides a good clinical outcome for NOA patients with severe spermatogenic impairment, including the rate of good quality D3 embryos, the rate of good quality D5 embryos, and the clinical pregnancy rate. However, our data suggested that both the TESA and MESA groups had better embryonic development and clinical outcomes than the mTESE group.

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“… 6 7 Many studies showed that the sperm acquisition rate of Micro-TESE is higher than that of traditional testicular sperm extraction. 8 For example, Schlegel 9 found that the rates of sperm acquisition (median [interquartile range, IQR]) are 45% (24%–68%) in traditional TESE and 63% (42%–81%) in Micro-TESE. Amer et al .…”

Section: Introductionmentioning

confidence: 99%

Predictive factors for successful sperm retrieval by microdissection testicular sperm extraction in men with nonobstructive azoospermia and a history of cryptorchidism

Qin

Chen

et al. 2022

Asian J Androl

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This study aims to explore the factors influencing the success rate of the microdissection testicular sperm extraction (Micro-TESE) in patients with nonobstructive azoospermia (NOA) and cryptorchidism. Clinical data of 162 patients with cryptorchidism who underwent Micro-TESE due to infertility from December 2015 to May 2020 in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. In the univariate analysis, significant differences in the age of patient at the time of orchidopexy (median [interquartile range, IQR]: 7.0 [4.0–11.0] years vs 11.5 [9.0–14.5] years, P < 0.001), interval between orchidopexy and Micro-TESE (mean ± standard deviation: 17.5 ± 5.0 years vs 14.4 ± 4.4 years, P < 0.001), severity of cryptorchidism (unilateral [62.8%] vs bilateral [31.6%], P < 0.001; location of cryptorchidism, intra-abdominal [27.3%] vs inguinal [44.8%] vs suprascrotal [66.7%], P < 0.001), volume of the dominant testis (median [IQR]: 17.00 [15.00–19.00] ml vs 14.50 [11.75–16.25] ml, P < 0.001), and levels of follicle-stimulating hormone (FSH; P = 0.004) and testosterone ( P = 0.006) were observed between the successful and failed sperm extraction groups. After conducting the multivariate analysis, four of these factors, including unilateral/bilateral cryptorchidism ( P < 0.001), location of cryptorchidism ( P = 0.032), age of orchidopexy ( P < 0.001), and dominant testicular volume, were adopted in the clinical prediction model to evaluate preoperatively the success rate of Micro-TESE for patients with NOA and cryptorchidism. The likelihood of successful sperm retrieval by Micro-TESE in men with NOA and cryptorchidism increased in patients with mild forms of cryptorchidism.

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Clinical comparison between conventional and microdissection testicular sperm extraction for non-obstructive azoospermia: Understanding which treatment works for which patient

Cited by 19 publications

References 14 publications

Evaluating the quality of reported outcomes for microsurgical TESE in men with non‐obstructive azoospermia: A methodological analysis

Evaluating the quality of reported outcomes for microsurgical TESE in men with non‐obstructive azoospermia: A methodological analysis

Comparison of the Effects of Different Testicular Sperm Extraction Methods on the Embryonic Development of Azoospermic Men in Intracytoplasmic Sperm Injection (ICSI) Cycles: A Retrospective Cohort Study

Predictive factors for successful sperm retrieval by microdissection testicular sperm extraction in men with nonobstructive azoospermia and a history of cryptorchidism

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