Testicular histopathological diagnosis as a predictive factor for retrieving spermatozoa for ICSI in non-obstructive azoospermic patients

Abstract

Objective: Histological testicular pattern has a predictive role in the possibility of finding spermatozoa for ICSI in cases of non-obstructive azoospermia because some individuals could show residual spermatogenic sites in the testis. The aim of this study was to evaluate the sperm retrieval rate in each of the histopathological groups (hypospermatogenesis-Hypo, spermatogenic maturation arrest-MA, Sertoli cell only-SCO and testicular hyalinization) in patients assisted in our clinic.Materials and Methods: Retrospective study from March 1997 to October 2002. We analyzed 14 patients with mean age of 34.3 ± 0.7, with non-obstructive azoospermia. All patients were submitted to previous diagnostic biopsy (Bx) elsewhere and came to our institution for treatment. After an average of 12 months (8 -20), they were submitted to a new Bx procedure to retrieve sperm.Results: Previous diagnostic Bx showed the following histopathological results: 5 patients with MA, 4 with Hypo and 5 SCO. In the following Bx (for sperm retrieval) spermatozoa was found in 33% of the procedures in patients with MA, 50% in patients with Hypo and 40% of the procedures in patients with SCO.Conclusion: Previous diagnostic Bx can help in patient counseling concerning the result of sperm retrieval.

Clinical outcome of emergency egg vitrification for women when sperm extraction from the testicular tissues of the male partner is not successful

“…As mentioned previously, although diagnostic biopsy has significant predictive value, the chance that sperm cannot be retrieved on the day of oocyte retrieval is 25% -30% [Glina et al 2005]. Some have suggested that the cryopreservation of sperm from TESE before treatment should be implemented to prevent this situation [Wu et al 2005].…”

“…However, spermatogenesis in NOA is usually limited, with only small foci spread over limited areas, so retrieving sperm can be a challenge. Diagnostic biopsy has significant predictive value, but the chance that no sperm will be found is 25%-30% [Glina et al 2005]. If sperm are not obtained then cryopreservation of oocytes or use of a sperm donor is the only possible alternative.…”

Early Versus Late Maturation Arrest: Reproductive Outcomes of Testicular Failure

“…More advanced histopathological results, such as MA and hypospermatogenesis, have correlated with the detection of spermatozoa during initial and repeat TESE. 23,24 Favorable testicular histopathology, such as late MA and hypospermatogenesis, may also influence the therapeutic effects of clomiphene citrate 15 and varicocele repair. 25 …”

Prognostic factors for sperm retrieval in non-obstructive azoospermia

“…However, its use is limited, as the patient must undergo a prognostic biopsy, which adds a surgical procedure. The worst pattern for sperm recovery is Sertoly cell-only syndrome, which has a rate of sperm retrieval ranging from 4-51%; maturation arrest (8-80%) is affects sperm recovery adversely, while hypospermatogenesis produces high rates of sperm recovery (80-100%) (3,28,29). …”

“…Prognostic factors have included testis size, follicle stimulating hormone (FSH), inhibin beta, the etiology of infertility, and genetic alterations; however, the histological testicular pattern remains the best predictor of sperm retrieval, although with the inconvenience of a second invasive procedure (3). …”