No relationship between biopsy sites near the main testicular vessels or rete testis and successful sperm retrieval using conventional or microdissection biopsies in 220 non-obstructive azoospermic men

Abstract

In 220 consecutive patients with non-obstructive azoospermia, sperm retrieval was attempted by a combination of conventional and microdissection testicular sperm extraction (TESE). For sperm retrieval, 2-3 conventional biopsies were performed followed by a microdissection TESE in cases of negative conventional biopsies. During the surgery, the vasculature of the testis was assessed using the operative microscope, and the location of positive biopsies was registered in relation to the blood supply. The overall sperm retrieval rate was 58.2%. From the initial conventional biopsies, sperm could be retrieved in 46.8% of the patients. With microdissection TESE, sperm could be retrieved from an additional 11.4% of the patients. The further use of microdissection TESE improved the sperm retrieval rate significantly (P50.017). No significant accumulation of positive biopsies was found towards the rete testis or the main testicular vessels.

Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis

“…After screening, 21 of them met our inclusion criteria and were finally enrolled in our study. 2 7 8 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 The flow diagram of our selection process is shown in Figure 1 . There were a total of 4364 patients with NOA in these included studies.…”

Microdissection TESE is superior to conventional TESE in patients with nonobstructive azoospermia caused by Y chromosome microdeletions

“…The present data showed the superiority concerning the SR rate of micro-TESE compared to the conventional multilocular TESE in patients with AZFc, despite the relatively small group of patients. For other forms of NOA, we have already demonstrated the superiority of micro-TESE compared to conventional multilocular TESE (Schwarzer et al, 2013, Schwarzer et al, 2003. All patients with Y chromosome microdeletions, in whom the deletion not or not only relates to the AZFc region of the Y chromosome, the SR rates appear extremely low as already described in the literature (Simoni et al, 2008;Navarro-Costa et al, 2010;Krausz et al, 2014).…”

“…For other forms of NOA, we have already demonstrated the superiority of micro-TESE compared to conventional multilocular TESE (Schwarzer et al, 2013, Schwarzer et al, 2003. For other forms of NOA, we have already demonstrated the superiority of micro-TESE compared to conventional multilocular TESE (Schwarzer et al, 2013, Schwarzer et al, 2003.…”

“…1). Our surgical technique, similar to that of Schlegel (1999), was carried out in a standardised procedure and has been described in detail by us (Schwarzer et al, 2013). 2).…”

“…2). Our surgical technique, similar to that of Schlegel (1999), was carried out in a standardised procedure and has been described in detail by us (Schwarzer et al, 2013). Both multilocular and microsurgical TESE were carried out in an operating room of the IVF centre located next to the IVF laboratory, so that an immediate interaction of the embryologist and the microsurgeon during the surgery was guaranteed.…”