Enzymatic digestion plus mechanical searching improves testicular sperm retrieval in non-obstructive azoospermia cases

A new method to process testicular sperm: combining enzymatic digestion, accumulation of spermatozoa, and stimulation of motility

“…Another important finding of this work [18] was the fact that after 24 h the mean vitality of spermatozoa exposed to enzymatic medium remained similar to that of an untreated control group clearly indicating the safety of the procedure. In bad prognosis patients enzymatic digestion of TESE material proved to be the very last alternative since 7-26 % of TESE suspensions found to be sperm-negative after mechanical mincing revealed usable spermatozoa after enzymatic treatment of the same samples [24][25][26].…”

“…What all publications mentioned above [16,18,[24][25][26][27] have in common is that after enzymatic digestion the embryologists centrifuged the final testicular sperm suspension and the associated pellet was resuspended in culture medium droplets on an ICSI dish. This approach often results in high concentrations of cell contaminants in the final specimen for ICSI.…”

Role of tissue digestion and extensive sperm search after microdissection testicular sperm extraction

“…We have previously reported higher sperm retrieval rates in men with cryptorchidism (15); therefore, this observation is not surprising. Aydos et al (8) evaluated the role of enzymatic digestion of testicular tissue following mechanical processing in 177 patients undergoing micro-TESE. They reported a sperm retrieval rate of 36% following mechanical mincing.…”

“…However, sperm are not always successfully identified in the OR; therefore, a meticulous laboratory-based search of the mechanically processed testicular tissue, including enzymatic treatment, can be performed to improve the chances of finding sperm (7). A study from Turkey reported a 33% chance of finding sperm following chemical digestion when sperm were not initially found by mechanical mincing (8).…”

Sperm donation and its application in China: a 7-year multicenter retrospective study

“…2 The success of this procedure has led to a reduced frequency of artificial insemination with donor sperm (AID). However, for couples seeking a healthy baby, AID remains an attractive alternative for several reasons, including a risk of Sertoli cellonly syndrome (there are no germ cells in testis), the high incidence of failed ICSI procedures and the increased genetic risks for offspring of ICSI fertilization.…”