In the era of micro-dissection sperm retrieval (m-TESE) is an isolated testicular biopsy necessary in the management of men with non-obstructive azoospermia?

2011 ◽  
Vol 109 (3) ◽  
pp. 418-424 ◽  
Author(s):  
Jas Kalsi ◽  
Meen-Yau Thum ◽  
Asif Muneer ◽  
Hossam Abdullah ◽  
Suks Minhas
Keyword(s):  
Testicular Biopsy ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval

Sperm Retrieval in the Obstructive, Nonobstructive Azoospermic and Aspermic Patients

2019 ◽  
Author(s):  
Ryan Flannigan ◽  
Peter N. Schlegel ◽  
E. Darracott Vaughan Jr.
Keyword(s):  
Key Words ◽  
Testicular Biopsy ◽  
Obstructive Azoospermia ◽  
Male Factor Infertility ◽  
Nonobstructive Azoospermia ◽  
Male Factor ◽  
Sperm Retrieval ◽  
Diagnostic Investigation ◽  
Work Up ◽  
Defective Spermatogenesis

Sperm retrieval includes essential procedures in the treatment and management of male factor infertility. Appropriate diagnostic investigation is necessary to correctly identify the etiology of azoospermia among obstructive, nonobstructive (defective spermatogenesis), and aspermia. In this chapter, we discuss the necessary work-up of an individual presenting with azoospermia along with the relevant medical and surgical management to optimize success with surgical sperm retrieval. This review contains 7 figures, 2 tables, and 68 references.  Key Words: anejaculation, azoospermia, MESA, microTESE, nonobstructive azoospermia, obstructive azoospermia, PESA, TESE, testicular biopsy

Testicular biopsy is not needed for diagnosis when surgical sperm retrieval is used for ICSI in obstructive azoospermia

2002 ◽  
Vol 1 (1) ◽  
pp. 181
Author(s):  
D. Van Der Schoot ◽  
L. Ramos ◽  
D. Braat ◽  
J. Kremer ◽  
A. Wetzels ◽  
...  
Keyword(s):  
Testicular Biopsy ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval

scholarly journals Novel Variants in HFM1 Lead to Male Infertility Due to Non-obstructive Azoospermia

2021 ◽  
Author(s):  
Dongdong Tang ◽  
Mingrong Lv ◽  
Yang Gao ◽  
Huiru Cheng ◽  
Kuokuo Li ◽  
...  
Keyword(s):  
Male Infertility ◽  
Y Chromosome ◽  
Testicular Biopsy ◽  
Severe Form ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval ◽  
Gene Variation ◽  
Y Chromosome Microdeletions ◽  
Whole Exome

Abstract Background Non-obstructive azoospermia (NOA) is the most severe form of male infertility. More than half of the NOA patients were idiopathic for their etiology, in whom it’s difficult to retrieve sperm despite the application of microsurgical testicular sperm extraction (microTESE). Therefore, we conducted to this study to identify the potential genetic factors responsible for NOA, and investigate the sperm retrieval rate of microTESE for the genetic defected NOA.Methods One NOA patient from a consanguineous family (F1-II-1) and fifty NOA patients from non-consanguineous families were included in the study. Semen analyses, chromosome karyotypes, screening of Y chromosome microdeletions, sex hormone testing, and subsequent testicular biopsy were performed to categorize NOA or obstructive azoospermia. Potentialgenetic variants were identified by whole exome sequencing (WES),and confirmed by Sanger sequencing in F1 II-1. The candidate genes were screened in the other fifty NOA patients. Further experiments including quantitative real time-polymerase chain reaction and western blotting were performed to verify the effects of gene variation on gene expression.Results Normal somatic karyotypes and Y chromosome microdeletions were examined in all patients. Hematoxylin and eosin staining (H&E) of the testicular tissues suggested meiotic arrest, and a novel homozygous HFM1 variant (c.3490C>T: p.Q1164X) was identified in F1 II-1. Furthermore, another homozygous HFM1 variant (c.3470G>A: p.C1157Y) was also verified in F2 II-1 from the fifty NOA patients. Significantly decreased expression levels of HFM1 mRNA and protein were observed in the testicular tissues of these two mutants compared with controls. MicroTESE was performed in these two patients, while no sperm were retrieved. Conclusions Our study identified two novel homozygous variants of HFM1 that are responsible for spermatogenic failure and NOA, even microTESE can not contribute to retrieve sperm in these patients.

Techniques for sperm recovery in assisted reproduction

1999 ◽  
Vol 7 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Sarah K Girardi ◽  
Peter N Schlegel
Keyword(s):  
Assisted Reproduction ◽  
Testicular Biopsy ◽  
Surgical Reconstruction ◽  
Significant Heterogeneity ◽  
Obstructive Azoospermia ◽  
Donor Insemination ◽  
Nonobstructive Azoospermia ◽  
Sperm Retrieval ◽  
Donor Sperm ◽  
Sperm Aspiration

During the past decade, few fields in medicine have changed as dramatically as reproductive medicine and the treatment of male infertility. Whereas previously only men with obstructive azoospermia were candidates for treatment, either through surgical reconstruction or sperm aspiration, now even men with nonobstructive azoospermia are able to achieve pregnancies without having to resort to donor sperm. The extraordinary success of assisted reproduction after sperm retrieval for azoospermic men is the result of three important discoveries. First is the clinical observation that epididymal transit of sperm is not required for successful fertilization. Second is the recognition that significant heterogeneity in testicular biopsy specimens exists. Lastly is the advent of intracytoplasmic sperm injection (ICSI), which has enabled fertilization regardless of the degree of sperm impairment or retrieval source as long as sperm are viable. These three discoveries have enabled fertilizations and pregnancies for men previously referred for donor insemination or adoption, and have therefore broadened the indications for sperm retrieval. This review is intended to describe in detail the available techniques for the recovery of sperm, with emphasis on the latest technique, testicular microdissection for sperm retrieval in nonobstructive azoospermia.

scholarly journals Novel variants in helicase for meiosis 1 lead to male infertility due to non-obstructive azoospermia

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Dongdong Tang ◽  
Mingrong Lv ◽  
Yang Gao ◽  
Huiru Cheng ◽  
Kuokuo Li ◽  
...  
Keyword(s):  
Male Infertility ◽  
Exome Sequencing ◽  
Whole Exome Sequencing ◽  
Genetic Factors ◽  
Testicular Biopsy ◽  
Severe Form ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval ◽  
Whole Exome

Abstract Background Non-obstructive azoospermia (NOA) is the most severe form of male infertility; more than half of the NOA patients are idiopathic. Although many NOA risk genes have been detected, the genetic factors for NOA in majority of the patients are unknown. In addition, it is difficult to retrieve sperm from these patients despite using the microsurgical testicular sperm extraction (microTESE) method. Therefore, we conducted this genetic study to identify the potential genetic factors responsible for NOA and investigate the sperm retrieval rate of microTESE for genetically deficient NOA patients. Methods Semen analyses, sex hormone testing, and testicular biopsy were performed to categorize the patients with NOA. The chromosome karyotypes and Y chromosome microdeletion analyses were used to exclude general genetic factors. Whole exome sequencing and Sanger sequencing were performed to identify potential genetic variants in 51 patients with NOA. Hematoxylin and eosin staining (H&E) and anti-phosphorylated H2AX were used to assess the histopathology of spermatogenesis. Quantitative real time-polymerase chain reaction, western blotting, and immunofluorescence were performed to verify the effects of gene variation on expression. Results We performed whole exome sequencing in 51 NOA patients and identified homozygous helicase for meiosis 1(HFM1) variants (NM_001017975: c.3490C > T: p.Q1164X; c.3470G > A: p.C1157Y) in two patients (3.9%, 2/51). Histopathology of the testis showed that spermatogenesis was completely blocked at metaphase in these two patients carrying the HFM1 homozygous variants. In comparison with unaffected controls, we found a significant reduction in the levels of HFM1 mRNA and protein expression in the testicular tissues from these two patients. The patients were also subjected to microTESE treatment, but the sperms could not be retrieved. Conclusions This study identified novel homozygous variants of HFM1 that are responsible for spermatogenic failure and NOA, and microTESE did not aid in retrieving sperms from these patients.

scholarly journals FSH levels and testicular volumes are associated with the severity of testicular histopathology in men with non-obstructive azoospermia

2021 ◽  
Author(s):  
Parviz K. Kavoussi ◽  
Kayla Hudson ◽  
G. Luke Machen ◽  
Maya Barsky ◽  
Dan I. Lebovic ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Testicular Biopsy ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Sperm Retrieval ◽  
Maturation Arrest ◽  
Early Maturation ◽  
Potential Association ◽  
The Mean

Abstract Purpose The purpose of this study is to assess a potential association between FSH levels and testicular volumes with the severity of testicular histopathology on testicular biopsy in men with non-obstructive azoospermia (NOA) undergoing microdissection testicular sperm extraction (microTESE). Methods A retrospective chart review was performed from the electronic health records of men who underwent microTESE with NOA. Results Eighty-six men with NOA underwent microTESE with concomitant testicular biopsy for permanent section to assess the testicular cellular architecture. The histopathological patterns were categorized by severity indicating the odds of sperm retrieval into 2 categories. The unfavorable category included Sertoli cell only pattern and early maturation arrest (n = 50) and the favorable category included late maturation arrest and hypospermatogenesis patterns (n = 36). In the men with unfavorable histopathologic patterns, the mean FSH level was 22.9 ± 16.6 IU/L, and the mean testicular volume was 10.4 ± 6.0 cc. This was in comparison to men with favorable histopathologic patterns revealing a mean FSH level of FSH 13.3 ± 12.0 with a mean testicular volume of 13.3 ± 5.9 cc. There was a statistically significant higher FSH level in men with unfavorable histopathology than favorable (p = 0.004) as well as a significant smaller mean testicular volume in men with unfavorable histopathology (p = 0.029). Conclusions Higher serum FSH levels and smaller testicular volumes are associated with more severe testicular histopathological patterns in men with NOA.

Can Testicular Size Be a Predictive Factor for Successful Sperm Retrieval in Patients with Non Obstructive Azoospermia?

2019 ◽  
pp. 1
Author(s):  
Omer Yumusak ◽  
Mehmet Cinar ◽  
Serkan Kahyaoglu ◽  
Yasemin Tasci ◽  
Gul Nihal Buyuk ◽  
...  
Keyword(s):  
Follicle Stimulating Hormone ◽  
Significant Risk ◽  
High Serum ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Total Testosterone ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Stimulating Hormone

<p><strong>Objective:</strong> Non-obstructive azoospermia, defined as absence of spermatozoa in the ejaculate caused by impaired spermatogenesis, is the most severe cause of male infertility. It is typically presented as high serum follicle stimulating hormone levels and atrophic testis. The combination of intracytoplasmic sperm injection and Microdissection testicular sperm extraction allows these infertile men the opportunity to have their own children from their own testis. Our aim was to evaluate the outcomes of micro-Testicular sperm extraction in men with atrophic testis.</p><p><strong>Study Design:</strong> The medical records of 80 non-obstructive men with azoospermia who underwent micro-TESE were retrospectively evaluated. We assessed clinical parameters; age, duration of infertility, smoking, chromosomal karyotype, Y chromosome microdeletion, follicle stimulating hormone, luteinizing hormone, total testosterone and testicular volume in relation with Microdissection testicular sperm extraction results.</p><p><strong>Results:</strong> Testicular sperm retrieval rate was 53% in 80 patients. Testicular volume, serum follicle stimulating hormone and total testosterone concentrations showed correlation with the results of sperm retrieval. These three parameters were found to be significant risk factors with testicular sperm extraction negative patients (p&lt;0.001). The odds ratios (95% CI) were 6.39 (1.25–26.58), 1.24 (1.11-1.36), 1.13 (0.99-1.21) respectively. Testicular volume was found to be a discriminative parameter in patients with negative sperm retrieval. The cut-off point was established as 6.75 ml for testicular volume with 88.1% sensitivity, 62.1% specificity.</p><p><strong>Conclusion:</strong> Microdissection testicular sperm extraction is the most effective procedure for patients with non-obstructive azoospermia. Testicular volume, serum follicle stimulating hormone and testosterone levels can be predictive factors for sperm retrieval in men with non-obstructive azoospermia.</p>

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