Faculty Opinions recommendation of Predictive factors for sperm retrieval from males with azoospermia who are eligible for testicular sperm extraction (TESE).

Objective: 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.Study Design: 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.Results: 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<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.Conclusion: 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.

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Microsurgical Testicular Sperm Extraction (MicroTESE) sperm retrieval rate (SRR) post Testicular Sperm Aspiration (TESA)

Fertility and Sterility ◽

10.1016/j.fertnstert.2016.07.870 ◽

2016 ◽

Vol 106 (3) ◽

pp. e306-e307

Author(s):

A.H. AlMalki ◽

A. Zini

Keyword(s):

Testicular Sperm Extraction ◽

Testicular Sperm ◽

Sperm Retrieval ◽

Retrieval Rate ◽

Sperm Aspiration ◽

Testicular Sperm Aspiration

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Intraoperative assessment of tubules in predicting microdissection testicular sperm extraction outcome in men with Sertoli cell-only syndrome

Journal of International Medical Research ◽

10.1177/0300060518809257 ◽

2018 ◽

Vol 47 (2) ◽

pp. 722-729 ◽

Cited By ~ 1

Author(s):

Yang Yu ◽

Qi Xi ◽

Ruixue Wang ◽

Hongguo Zhang ◽

Leilei Li ◽

...

Keyword(s):

Sertoli Cell ◽

Follicle Stimulating Hormone ◽

Seminiferous Tubules ◽

Testicular Sperm Extraction ◽

Testicular Sperm ◽

Sperm Retrieval ◽

Intraoperative Assessment ◽

Retrieval Rate ◽

Surgical Suture ◽

Tubule Diameter

Objective This study aimed to assess the value of measuring the tubule diameter during microdissection testicular sperm extraction (micro-TESE) in predicting outcomes in patients with Sertoli cell-only syndrome (SCOS). Methods Fifty-six consecutive patients with SCOS were included. Patients were classified into two groups on the basis of the diameter of seminiferous tubules measured against 5/0 surgical suture (≥100 µm or <100 µm). Results The sperm retrieval rate (SRR) in men with a tubule diameter ≥100 µm was significantly lower than that in those with <100 µm (3.1% vs. 25.0%). The SRR from the contralateral testis in men with a tubule diameter ≥100 µm was lower than that in those with <100 µm (0% vs. 14.3%). Men with a tubule diameter ≥100 µm had a significantly larger testis and lower follicle-stimulating hormone levels than did men with <100 µm (8.1 ± 2.4 vs. 5.3±1.8 mL, 19.9 ± 9.7 vs. 25.9 ± 7.1 mIU/mL, respectively). Conclusions The diameter of tubules is a useful predictor for a successful SRR in men with SCOS. Intraoperative assessment of homogeneous large tubules allows some men to perform a limited (superﬁcial) contralateral micro-TESE after no spermatozoa are initially identified.

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