scholarly journals Sperm retrieval predictive factors and testicular histology in nonobstructive azoospermia patients

2020 ◽  
Vol 31 (2) ◽  
pp. 51
Author(s):  
Hong-Chiang Chang ◽  
Ming-Wei Li ◽  
I-Ni Chiang ◽  
Yi-Kai Chang ◽  
Shuo-Meng Wang
Keyword(s):  
Predictive Factors ◽  
Nonobstructive Azoospermia ◽  
Sperm Retrieval ◽  
Testicular Histology

scholarly journals Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

2021 ◽  
Vol 10 (3) ◽  
pp. 387 ◽  
Author(s):  
Ettore Caroppo ◽  
Giovanni M. Colpi
Keyword(s):  
Current Knowledge ◽  
Hormonal Treatment ◽  
Hormonal Control ◽  
Testicular Sperm Extraction ◽  
Nonobstructive Azoospermia ◽  
Sperm Retrieval ◽  
Hormonal Stimulation ◽  
Testosterone Levels ◽  
Retrieval Rate ◽  
Standard Clinical Practice

Hormonal stimulation of spermatogenesis prior to surgery has been tested by some authors to maximize the sperm retrieval yield in patients with nonobstructive azoospermia. Although the rationale of such an approach is theoretically sound, studies have provided conflicting results, and there are unmet questions that need to be addressed. In the present narrative review, we reviewed the current knowledge about the hormonal control of spermatogenesis, the relationship between presurgical serum hormones levels and sperm retrieval rates, and the results of studies investigating the effect of hormonal treatments prior to microdissection testicular sperm extraction. We pooled the available data about sperm retrieval rate in patients with low vs. normal testosterone levels, and found that patients with normal testosterone levels had a significantly higher chance of successful sperm retrieval compared to those with subnormal T levels (OR 1.63, 95% CI 1.08–2.45, p = 0.02). These data suggest that hormonal treatment may be justified in patients with hypogonadism; on the other hand, the available evidence is insufficient to recommend hormonal therapy as standard clinical practice to improve the sperm retrieval rate in patients with nonobstructive azoospermia.

Male Infertility: Surgical Treatment (Varicocele, Microsurgical Reconstruction, TUR Ejaculatory Ducts)

2019 ◽  
Author(s):  
Vanessa L. Dudley ◽  
Marc Goldstein
Keyword(s):  
Intrauterine Insemination ◽  
Ejaculatory Duct ◽  
Obstructive Azoospermia ◽  
Male Factor Infertility ◽  
Nonobstructive Azoospermia ◽  
Male Factor ◽  
Sperm Retrieval ◽  
Donor Sperm ◽  
Vitro Fertilization

Male factor infertility contributes to at least half of all cases of infertility in couples. The most common causes of male factor infertility are impaired sperm production due to varicoceles, obstruction of the ductal system, and genetic defects causing nonobstructive azoospermia. A majority of these underlying conditions are treatable. Even when in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) is necessary, treatment of men has been shown to improve the outcomes of IVF-ICSI and potentially increase the chances of finding sperm with microdissection sperm extraction in some cases of nonobstructive azoospermia. Important advances in the field include abundant evidence now supporting microsurgical repair of varicocele in varicocele-associated nonobstructive azoospermia prior to IVF-ICSI or attempted surgical sperm retrieval. Advances in techniques for reconstruction of obstruction is dependent on the surgeon’s skill in creating a tension-free and leak-proof mucosa-to-mucosa accurate approximation with a good blood supply and healthy mucosa and muscularis and can result in higher patency rates. Treating the men often allows upgrading men from being solely candidates for donor sperm or adoption to candidates for ICF-ICSI with surgically retrieved testicular sperm to allowing IVF-ICSI with ejaculated sperm and from IVF-ICSI with ejaculated sperm to allowing the simpler intrauterine insemination and, finally, the possibility of a naturally conceived pregnancy. This review contains 27 figures, 1 table, and 69 references. Key Words: microsurgery, obstructive azoospermia, transurethral resection of the ejaculatory duct, varicocele, vasectomy reversal, vasoepididymostomy, vasography, vasovasostomy

scholarly journals Varicocele Repair Improves Testicular Histology in Men with Nonobstructive Azoospermia

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Murat Ustuner ◽  
Hasan Yilmaz ◽  
Ufuk Yavuz ◽  
Seyfettin Ciftci ◽  
Ali Saribacak ◽  
...  
Keyword(s):  
Extraction Procedure ◽  
Testicular Biopsy ◽  
Testicular Tissue ◽  
High Serum ◽  
Histopathological Analysis ◽  
Nonobstructive Azoospermia ◽  
Biopsy Specimens ◽  
Testicular Histology ◽  
Late Maturation ◽  
Varicocele Repair

Objective. To determine the histopathological differences after varicocele repair in testicular tissue in males with nonobstructive azoospermia.Methods. Between 2009 and 2014, 45 men with complete azoospermia and palpable varicocele, presenting with primary infertility of at least 1 year, undergoing varicocele repair at our institution were selected for the study. A standard systematic testicular 6-core Tru-Cut biopsy was performed during varicocele repair. Other biopsies were obtained from each testicle of all patients at the time of microscopic sperm extraction procedure.Results. Nineteen patients were selected for the study. Testicular biopsy specimens were classified as Sertoli cell only on preoperative histopathological analysis in 14 patients. After varicocele repair, focal spermatogenesisn=3and late maturation arrestn=2were found in these patients. Average Johnsen score was significantly increased after varicocelectomyP=0.003. Motile sperm was found in one patient on postoperative semen analyses and in 10 more patients in the microscopic sperm extraction procedure. Preoperative high serum follicle stimulating hormone level and venous reflux were significantly and negatively correlated with the increase in average Johnsen scoreP<0.05.Conclusions. Our findings suggest significant improvement in testicular histology after varicocele repair.

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