Microscopic Testicular Sperm Extraction

Abstract

Azoospermia, the complete absence of sperms in the ejaculate is found in 1% ofnormal males and 10-15% of infertile couples. Surgical sperm retrieval (SSR) and use of spermsfor ICSI/IVF offers an opportunity of parenting to the male factor infertile couples. Micro-TESEgives higher surgical sperms retrieval rates in those patients in whom the chances of spermretrieval otherwise are very low. Objectives: To evaluate the outcome of Microscopic TesticularSperm Extraction (Micro-TESE) in different patients groups of non-obstructive azoospermia,in terms of testicular volume, histopathology, hormones levels as well as cytogenetic variants.Study Design: Retrospectively reviewed. Setting: Urology Division, King Fahd Medical City,Riyadh in collaboration with King Abdullah Reproductive Medical Unit (RMU). Period: January2011 to January 2016. Material & Methods: Fifty-four patients of primary and secondary infertilityage range of 29 to 65 years who had undergone Microscopic Testicular Sperm Extraction(Micro-TESE). Outcome measures: Finding of sperm in testicular specimen extracted bymicroscopic testicular dissection. Results: Out of 54 patients, hormonal abnormalities werefound in 45% patients and 65% had low volume testes. Abnormal histology was found in 23%patients and 9% had chromosomal abnormalities. Overall sperm retrieval rate in all groups was33%. Sperm retrieval rate was 34 % in patients with small volume testes (<15ml), 42% patientswith abnormal hormones (FSH), 33% patients with abnormal histology and 38% in patientswith chromosomal abnormalities. Minor complications (small hematoma and orchalgia) wereobserved in two (3.7%) patients. Conclusion: Micro-TESE is a valid option for sperm retrieval inpatients in which probability of sperm retrieval is otherwise very low.