Background and Aims:

 Microdissection testicular sperm extraction TESE (MD-TESE), which can improvesurgical sperm retrieval rate is widely applied in sperm retrieval surgery in non-obstructive azoospermic (NOA) patients. We assessed whether MD-TESE can improve sperm retrieval rate as well as Intracytoplasmic sperm injection (ICSI) results.

Methods:

A retrospective comparative study involving 86 NOA patients who underwent 6-8 conventional multiple TESE (C-TESE) procedures was conducted. Another 116 NOA patients underwent MD-TESE. CTESE and MD-TESE were employed for the bilateral testis via a median raphe incision under spinal or local anesthesia with spermatic block.

Results:

Motile sperm recovery was achieved in 26 (30.2%) and 30 (25.8%) patients with C-TESE and MDTESE,respectively. Collected sperm was cryopreserved. All couples in which motile sperm was recovered received ICSI utilizing frozen-thawed sperm samples. Overall pregnancy rates of the C-TESE and MD-TESE groups were 23% (6/26) and 40% (12/30), respectively. Abortion was not observed in either group and healthy deliveries resulted. Statistical differences in sperm recovery and pregnancy rate were not evident between the groups (P=0.495, P=0.182, respectively). Moreover, no successful pre-operative predictors of sperm recovery were identified.

Conclusions:

These data demonstrated that MD-TESE does not improve sperm recovery rate; however, MD-TESE contributes to favorable pregnancy rate in NOA patients.

"/> Background and Aims:

 Microdissection testicular sperm extraction TESE (MD-TESE), which can improvesurgical sperm retrieval rate is widely applied in sperm retrieval surgery in non-obstructive azoospermic (NOA) patients. We assessed whether MD-TESE can improve sperm retrieval rate as well as Intracytoplasmic sperm injection (ICSI) results.

Methods:

A retrospective comparative study involving 86 NOA patients who underwent 6-8 conventional multiple TESE (C-TESE) procedures was conducted. Another 116 NOA patients underwent MD-TESE. CTESE and MD-TESE were employed for the bilateral testis via a median raphe incision under spinal or local anesthesia with spermatic block.

Results:

Motile sperm recovery was achieved in 26 (30.2%) and 30 (25.8%) patients with C-TESE and MDTESE,respectively. Collected sperm was cryopreserved. All couples in which motile sperm was recovered received ICSI utilizing frozen-thawed sperm samples. Overall pregnancy rates of the C-TESE and MD-TESE groups were 23% (6/26) and 40% (12/30), respectively. Abortion was not observed in either group and healthy deliveries resulted. Statistical differences in sperm recovery and pregnancy rate were not evident between the groups (P=0.495, P=0.182, respectively). Moreover, no successful pre-operative predictors of sperm recovery were identified.

Conclusions:

These data demonstrated that MD-TESE does not improve sperm recovery rate; however, MD-TESE contributes to favorable pregnancy rate in NOA patients.

"/>

Microdissection TESE (MD-TESE) Does not Improve Sperm Retrieval Rate but Contributes to Favorable Pregnancy Rate in Non-Obstructive Azoospermic (NOA) Patients

AUTHORS

Hatsuki Hibi 1 , * , Tadashi Ohori 2 , Yoshiaki Yamada 3 , Nobuaki Honda 3 , Chikako Ito 2 , Miho Sano 2 , Yoshiki Hashiba 2 , Yoshimasa Asada 2

1 Department of Urology, Kyoritsu General Hospital, [email protected], Japan

2 Department of Urology, Kyoritsu General Hospital, Japan

3 Department of Urology, Aichi Medical University School of Medicine, Japan

How to Cite: Hibi H, Ohori T, Yamada Y, Honda N, Ito C, et al. Microdissection TESE (MD-TESE) Does not Improve Sperm Retrieval Rate but Contributes to Favorable Pregnancy Rate in Non-Obstructive Azoospermic (NOA) Patients, Nephro-Urol Mon. Online ahead of Print ; 2(3):455-461.

ARTICLE INFORMATION

Nephro-Urology Monthly: 2 (3); 455-461
Article Type: Research Article
Received: October 19, 2009
Accepted: November 7, 2009
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Abstract

Background and Aims:

 Microdissection testicular sperm extraction TESE (MD-TESE), which can improvesurgical sperm retrieval rate is widely applied in sperm retrieval surgery in non-obstructive azoospermic (NOA) patients. We assessed whether MD-TESE can improve sperm retrieval rate as well as Intracytoplasmic sperm injection (ICSI) results.

Methods:

A retrospective comparative study involving 86 NOA patients who underwent 6-8 conventional multiple TESE (C-TESE) procedures was conducted. Another 116 NOA patients underwent MD-TESE. CTESE and MD-TESE were employed for the bilateral testis via a median raphe incision under spinal or local anesthesia with spermatic block.

Results:

Motile sperm recovery was achieved in 26 (30.2%) and 30 (25.8%) patients with C-TESE and MDTESE,respectively. Collected sperm was cryopreserved. All couples in which motile sperm was recovered received ICSI utilizing frozen-thawed sperm samples. Overall pregnancy rates of the C-TESE and MD-TESE groups were 23% (6/26) and 40% (12/30), respectively. Abortion was not observed in either group and healthy deliveries resulted. Statistical differences in sperm recovery and pregnancy rate were not evident between the groups (P=0.495, P=0.182, respectively). Moreover, no successful pre-operative predictors of sperm recovery were identified.

Conclusions:

These data demonstrated that MD-TESE does not improve sperm recovery rate; however, MD-TESE contributes to favorable pregnancy rate in NOA patients.

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