Multiple Testicular Sampling in Non-Obstructive Azoospermia-Is it Necessary?

Hauser, R.; Botchan, A.; Amit, A.; Yosef, D. Ben; Gamzu, R.; Paz, G.; Lessing, J. B.; Yogev, L.; Yavetz, H.

doi:10.1097/00005392-199905000-00112

Cited by 16 publications

(25 citation statements)

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“…We also found that a relatively high proportion of the men undergoing TESA (43%, 3/7) had a bilateral procedure, although we suspect that increasing the number of TESA attempts in the first testis (beyond two testicular aspirations) may have reduced that proportion (Hauser et al, 1998). One of the main issues with performing TESA (or a random open biopsy) in the setting of cryptozoospermia, is the uncertainty of the procedure outcome because it is difficult to identify a successful sperm retrieval in a timely fashion (i.e., rapid intra-operative identification of spermatozoa).…”

Section: Discussionmentioning

confidence: 68%

Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE) in men with cryptozoospermia

Alrabeeah

Wachter²,

Phillips³

et al. 2015

Andrology

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SUMMARYSeveral studies support of the use of testicular rather than ejaculated spermatozoa for intracytoplasmic sperm injection (ICSI) in couples with virtual azoospermia or cryptozoospermia, although this approach remains controversial. We sought to evaluate sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE) in men with cryptozoospermia. We conducted a retrospective study of 24 consecutive micro-TESEs in men with cryptozoospermia. We also evaluated the outcomes of seven consecutive TESAs (testicular sperm aspiration) in cryptozoospermic men during the same time period (January 2007 and September 2014). Micro-TESE and TESA were performed on the day prior to ICSI. Final assessment of sperm recovery (reported on the day of ICSI) was recorded as (i) successful (available spermatozoa for ICSI) or (ii) unsuccessful (no spermatozoa for ICSI). The decision to perform a unilateral or bilateral micro-TESE was guided by the intra-operative evaluation of sperm recovery from the first testicle. A unilateral procedure was performed in 87.5% (21/24) and 57% (4/7) of the micro-TESE and TESA cohorts, respectively. Sperm recovery was successful in 96% (23/24) of the men who underwent micro-TESE and 43% (3/7) of the men who underwent TESA (p < 0.01). The ICSI pregnancy rates (per embryo transfer) in the micro-TESE and TESA groups were comparable [33% (6/18) and 50% (1/2), respectively]. The data indicate that micro-TESE is a highly successful sperm retrieval technique for men with cryptozoospermia and few of these men will require a bilateral procedure. Moreover, sperm retrieval rates are higher with micro-TESE than TESA in this group of men.

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Section: Discussionmentioning

confidence: 68%

Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE) in men with cryptozoospermia

Alrabeeah

Wachter²,

Phillips³

et al. 2015

Andrology

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“…The TESE with multiple biopsies is considered the optimal option to improve the sperm retrieval rate [SSR] given that isolated regions of spermatogenic tissue are present. 22 However, the removal of large sample of testicular tissue can lead in some cases to testicular atrophy and potentially impair subsequent success SSR. 23 Therefore it is advisable that TESE with multiple biopsies should be considered a therapeutic rather than just diagnostic test.…”

Section: Discussionmentioning

confidence: 99%

Cryptorchidism and its impact on male fertility: a state of art review of current literature

Chung

Brock

2013

CUAJ

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Cryptorchidism is associated with impairment of germ cell maturation and subsequent infertility in adulthood. The present report details common scenarios of referral of men with prior history of cryptorchidism and orchidopexy seeking advice for infertility, and examines the association between cyrptorchidism and male infertility. The increase in the understanding of the hormonal profiles and patho-physiological changes in germ cell maturation in cryptorchid boys may potentially change our approach and management strategies. Improvement in sperm retrieval techniques and micromanipulation techniques, such as intracytoplasmic sperm injection, has led to excellent fertilization and pregnancy outcomes of treatment cycles.

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“…Several spermretrieval techniques have been developed, including TESE and fine-needle aspiration (FNA). TESE has been performed with multiple biopsies to increase the sperm retrieval rate (SRR) [28,29], but removal of large amounts of tissue could lead to testicular atrophy after surgical intervention [30]. FNA is another possible technique.…”

Section: Management Of Noa Retrieval Of Testicular Spermmentioning

confidence: 99%

Management of non‐obstructive azoospermia

Chiba

Enatsu

Fujisawa

2016

Reprod Medicine & Biology

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Non-obstructive azoospermia (NOA) is defined as no sperm in the ejaculate due to failure of spermatogenesis and is the most severe form of male infertility. The etiology of NOA is either intrinsic testicular impairment or inadequate gonadotropin production. Chromosomal or genetic abnormalities should be evaluated because there is a relatively high incidence compared with the normal population. Although rare, NOA due to inadequate gonadotropin production is a condition in which fertility can be improved by medical treatment. In contrast, there is no treatment that can restore spermatogenesis in the majority of NOA patients. Consequently, testicular extraction of sperm under an operating microscope (micro-TESE) has been the firstline treatment for these patients. Other treatment options include varicocelectomy for NOA patients with a palpable varicocele and orchidopexy if undescended testes are diagnosed after adulthood, although management of these patients remains controversial. Advances in retrieving spermatozoa more efficiently by micro-TESE have been made during the past decade. In addition, recent advances in biotechnology have raised the possibility of using germ cells produced from stem cells in the future. This review presents current knowledge about the etiology, diagnosis, and treatment of NOA.

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Multiple Testicular Sampling in Non-Obstructive Azoospermia-Is it Necessary?

Cited by 16 publications

References 0 publications

Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE) in men with cryptozoospermia

Sperm retrieval outcomes with microdissection testicular sperm extraction (micro-TESE) in men with cryptozoospermia

Cryptorchidism and its impact on male fertility: a state of art review of current literature

Management of non‐obstructive azoospermia

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