Abstract:Testicular sperm retrieval techniques associated with intracytoplasmic sperm injection have changed the field of male infertility treatment and given many azoospermic men the chance to become biological fathers. Despite the current use of testicular sperm extraction, reliable clinical and laboratory prognostic factors of sperm recovery are still absent. The objective of this article was to review the prognostic factors and clinical use of sperm retrieval for men with non-obstructive azoospermia.The PubMed data… Show more
“…This may be a reflection of the testicular histological patterns of hypospermatogenesis and maturation arrest that are more frequently seen in these groups, and are associated with higher sperm retrieval rates 39 . In keeping with this, all patients with post chemotherapy azoospermia and evidence of hypospermatogenesis on testicular biopsy had successful sperm retrieval.…”
Section: Post-chemotherapy Azoospermia and Mtesementioning
“…This may be a reflection of the testicular histological patterns of hypospermatogenesis and maturation arrest that are more frequently seen in these groups, and are associated with higher sperm retrieval rates 39 . In keeping with this, all patients with post chemotherapy azoospermia and evidence of hypospermatogenesis on testicular biopsy had successful sperm retrieval.…”
Section: Post-chemotherapy Azoospermia and Mtesementioning
“…Other proposed predictors of sperm retrieval success include FSH, testosterone, testis size, and inhibin B and although they provide some prognostic information none of them have been found to safely predict the success of mTESE or other sperm retrieval techniques (Glina & Vieira, 2013). The lack of accurate predictors would encourage the use of a prognostic approach to avoid unavailability of spermatozoa when ICSI is to be performed on collected oocytes.…”
Section: Discussionmentioning
confidence: 99%
“…Histopathology is one among many parameters that have been suggested as a method to predict outcomes of sperm retrieval (Glina & Vieira, 2013). However, in a number of studies on mTESE a biopsy for histology is only obtained during the surgical sperm retrieval thereby excluding the prognostic value of histopathological diagnosis (Tsujimura et al, 2002;Ramasamy et al, 2005;Turunc et al, 2010;Ghalayini et al, 2011).…”
SUMMARYPercutaneous testicular sperm aspiration (TESA) has been known for decades as a simple, minimally invasive approach to sperm retrieval in azoospermic men. Because of lower reported sperm retrieval rates (SRR) when compared with microdissection testicular sperm extraction (mTESE), many centers now use mTESE as the first choice for retrieving spermatozoa in nonobstructive azoospermia (NOA). Objectives of this study were to evaluate the outcome and safety of TESA and mTESE in the treatment of azoospermia and to investigate the usefulness of a prognostic TESA to individualize protocols for couples and limit the use of invasive testicular procedures. IRB approval was obtained to retrospectively evaluate 208 patients undergoing multiple needle-pass TESA between 1999 and 2014. Prognostic TESA was performed on 125 men with NOA and 82 with obstructive azoospermia (OA). Nine NOA men and 31 OA men with previously demonstrated spermatozoa had a subsequent therapeutic TESA while nine NOA men with a failed TESA proceeded to mTESE. Main outcome measures were complication rates and SRR. SRR of the prognostic TESA was 30% (38/125) for NOA men and 100% (82/82) for OA men. Eight/nine NOA men and 31/31 OA men had spermatozoa found for intracytoplasmic sperm injection in a subsequent therapeutic TESA. In nine NOA men in whom a TESA produced no spermatozoa, only one had spermatozoa found with mTESE. Overall complication rates of TESA and mTESE were 3% (7/267) and 21% (3/14), respectively. TESA provides reasonable SRR and is a safe procedure. Successful prognostic TESA indicates future success with therapeutic TESA. Men with a failed TESA have a limited chance of sperm retrieval using mTESE. Approaching azoospermic men with an initial prognostic TESA followed by either therapeutic TESA and/or mTESE is an efficient algorithm in the management of azoospermia and limits the use of more invasive procedures.
“…Similar results are found in many international studies. (15,17,18,19) . The predictive power of serum FSH for successful sperm retrieval is also analysed.…”
Section: Discussionmentioning
confidence: 99%
“…(10,11) The sperm recovery rates ranges from 90% to 100% for obstructive azoospermia using any of standard surgical technique (12) , but the sperm recovery rates for non-obstructive azoospermia range from 30-63% for TESE, and 43-63% for Micro-TESE; the rate for TEFNA is approximately 47%. (17) Out of all patients of azoospermia approximately 36% are due to obstructive azoospermia. (12) Thus on an average overall surgical success rate for sperm retrieval ranges between 50% to 70%.…”
Parenthood is one of the most universally desired goals in adulthood. After varicocele, azoospermia is the second major cause of infertility in men. Sperm retrieval in combination with
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