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A novel stepwise micro-TESE approach in non obstructive azoospermia
- Source :
- BMC Urology
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Background The purpose of the study was to investigate whether micro-TESE can improve sperm retrieval rate (SRR) compared to conventional single TESE biopsy on the same testicle or to contralateral multiple TESE, by employing a novel stepwise micro-TESE approach in a population of poor prognosis patients with non-obstructive azoospermia (NOA). Methods Sixty-four poor prognosis NOA men undergoing surgical testicular sperm retrieval for ICSI, from March 2007 to April 2013, were included in this study. Patients inclusion criteria were a) previous unsuccessful TESE, b) unfavorable histology (SCOS, MA, sclerahyalinosis), c) Klinefelter syndrome. We employed a stepwise micro-TESE consisting three-steps: 1) single conventional TESE biopsy; 2) micro-TESE on the same testis; 3) contralateral multiple TESE. Results SRR was 28.1 % (18/64). Sperm was obtained in both the initial single conventional TESE and in the following micro-TESE. The positive or negative sperm retrieval was further confirmed by a contralateral multiple TESE, when performed. No significant pre-operative predictors of sperm retrieval, including patients’ age, previous negative TESE or serological markers (LH, FSH, inhibin B), were observed at univariate or multivariate analysis. Micro-TESE (step 2) did not improve sperm retrieval as compared to single TESE biopsy on the same testicle (step 1) or multiple contralateral TESE (step 3). Conclusions Stepwise micro-TESE could represent an optimal approach for sperm retrieval in NOA men. In our view, it should be offered to NOA patients in order to gradually increase surgical invasiveness, when necessary. Stepwise micro-TESE might also reduce the costs, time and efforts involved in surgery.
- Subjects :
- Adult
Male
Microsurgery
medicine.medical_specialty
Sperm Retrieval
Biopsy
Urology
Population
030232 urology & nephrology
Testicle
ICSI
03 medical and health sciences
0302 clinical medicine
Text mining
Testis
medicine
Humans
education
azoospermia
micro-TESE
Micro-TESE
Azoospermia
Gynecology
education.field_of_study
030219 obstetrics & reproductive medicine
medicine.diagnostic_test
business.industry
General Medicine
medicine.disease
Spermatozoa
Sperm
medicine.anatomical_structure
Reproductive Medicine
TESE
Klinefelter syndrome
business
Research Article
Subjects
Details
- ISSN :
- 14712490
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- BMC Urology
- Accession number :
- edsair.doi.dedup.....d77bb29b4eabba5f7806eae5330c6f8b