Comparison of unilateral and bilateral microdissection testicular sperm extraction (MD-TESE) in patients with non-obstructive azoospermia: a prospective study.
Azoospermia
Bilateral
Inhibin B
Microdissection
Testicle
Unilateral
Journal
International urology and nephrology
ISSN: 1573-2584
Titre abrégé: Int Urol Nephrol
Pays: Netherlands
ID NLM: 0262521
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
24
04
2023
accepted:
05
06
2023
medline:
9
8
2023
pubmed:
18
6
2023
entrez:
18
6
2023
Statut:
ppublish
Résumé
To compare sperm retrieval rates between unilateral and bilateral microdissection testicular sperm extraction (MD-TESE) procedures in patients with non-obstructive azoospermia and to contribute to the literature by comparing them with literature data. This prospective study included 84 males with primary infertility who had azoospermic NOA, who had been married for at least one year, and whose female partners did not have a history of infertility. The study was conducted between January 2019 and January 2020. MD-TESE was applied bilaterally to 48% (n:41) (Group 1) and unilaterally to 52% (n:43) (Group 2) of the patients, and sperm retrieval rates were compared. There was no statistically significant difference between Group 1 patients and Group 2 patients in terms of sperm availability (61%, 56.5%, p=0.495, respectively). In addition, while no complications were observed in unilateral MD-TESEs, 3 complications were observed in bilateral MD-TESEs. In our study, it was determined that there was no significant difference between the groups in terms of sperm availability in patients with NOA. Considering the operative time and complication rates of bilateral MD-TESE in patients diagnosed with NOA and the possible MD-TESE procedures that may be performed later, we believe that unilateral MD TESE is a more preferable procedure for the patient and surgeon in this patient group.
Identifiants
pubmed: 37330932
doi: 10.1007/s11255-023-03668-0
pii: 10.1007/s11255-023-03668-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2177-2182Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AM (2000) WHO manual for the standardized investigation and diagnosis of the infertile male. Cambridge University Press, Cambridge
Göktolga Ü, Izetbegovic S, Rama A, Spahovic H, Göktaş C (2015) The first report from bosnia and herzegovina on micro-tese results in azoospermic patients. Med Arch 69(3):196
doi: 10.5455/medarh.2015.69.196-199
pubmed: 26261391
pmcid: 4500295
Bernie AM, Ramasamy R, Schlegel PN (2013) Predictive factors of successful microdissection testicular sperm extraction. Basic Clin Androl 23(1):1–7
doi: 10.1186/2051-4190-23-5
Raman JD, Schlegel PN (2003) Testicular sperm extraction with intracytoplasmic sperm injection is successful for the treatment of nonobstructive azoospermia associated with cryptorchidism. J Urol 170(4):1287–1290
doi: 10.1097/01.ju.0000080707.75753.ec
pubmed: 14501743
Jarow JP, Espeland MA, Lipshultz LI (1989) Evaluation of the azoospermic patient. J Urol 142(1):62–65
doi: 10.1016/S0022-5347(17)38662-7
pubmed: 2499695
Çayan S. Erkek infertilitesi değerlendirme, medikal ve cerrahi tedaviler
Ichioka K, Matsui Y, Terada N, Negoro H, Goto T, Ogawa O (2020) Three-dimensional simulation analysis of microdissection testicular sperm extraction for patients with non-obstructive azoospermia. Andrology 8(5):1214–1221
doi: 10.1111/andr.12812
pubmed: 32374923
pmcid: 7522677
Levin HS (1979) Testicular biopsy in the study of male infertility: its current usefulness, histologic techniques, and prospects for the future. Hum Pathol 10(5):569–584
doi: 10.1016/S0046-8177(79)80100-8
pubmed: 43278
Witt MA, Elsner C, Kort HI, Massey JB, Mitchell-Leef D, Toledo AA et al (1995) A live birth from intracytoplasmic injection of a spermatozoon retrieved from testicular parenchyma. J Urol 154(3):1136–1137
doi: 10.1016/S0022-5347(01)67001-0
pubmed: 7637066
Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S et al (1997) Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod (Oxford, England) 12(1):80–86
doi: 10.1093/humrep/12.1.80
Turunc T, Gul U, Haydardedeoglu B, Bal N, Kuzgunbay B, Peskircioglu L et al (2010) Conventional testicular sperm extraction combined with the microdissection technique in nonobstructive azoospermic patients: a prospective comparative study. Fertil Steril 94(6):2157–2160
doi: 10.1016/j.fertnstert.2010.01.008
pubmed: 20172512
Tsujimura A, Matsumiya K, Miyagawa Y, Tohda A, Miura H, Nishimura K et al (2002) Conventional multiple or microdissection testicular sperm extraction: a comparative study. Hum Reprod 17(11):2924–2929
doi: 10.1093/humrep/17.11.2924
pubmed: 12407050
Schlegel PN (1999) Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod 14(1):131–135
doi: 10.1093/humrep/14.1.131
pubmed: 10374109
Schlegel PN (ed) (2009) Nonobstructive azoospermia: a revolutionary surgical approach and results. Seminars in reproductive medicine. Springer, New York
Seo JT, Ko WJ (2001) Predictive factors of successful testicular sperm recovery in non-obstructive azoospermia patients. Int J Androl 24(5):306–310
doi: 10.1046/j.1365-2605.2001.00307.x
pubmed: 11554989
Plas E, Riedl CR, Engelhardt PF, Mühlbauer H, Pflüger H (1999) Unilateral or bilateral testicular biopsy in the era of intracytoplasmic sperm injection. J Urol 162(6):2010–2013
doi: 10.1016/S0022-5347(05)68089-5
pubmed: 10569558
Schulze W, Thoms F, Knuth U (1999) Testicular sperm extraction: comprehensive analysis with simultaneously performed histology in 1418 biopsies from 766 subfertile men. Hum Reprod 14(suppl_1):82–96
doi: 10.1093/humrep/14.suppl_1.82
pubmed: 10573026
Moein MR, Moein MR, Ghasemzadeh J, Pourmasoumi S (2015) Evaluation of sperm retrieval rate with bilateral testicular sperm extraction in infertile patients with azoospermia. Iran J Reprod Med 13(11):711
pubmed: 26730246
pmcid: 4695686
Ramasamy R, Reifsnyder JE, Husseini J, Eid P-A, Bryson C, Schlegel PN (2013) Localization of sperm during microdissection testicular sperm extraction in men with nonobstructive azoospermia. J Urol 189(2):643–646
doi: 10.1016/j.juro.2012.09.031
pubmed: 23260549
Franco G, Zavaglia D, Cavaliere A, Leonardo C, Petrucci F, De Cillis A et al (2009) 112 a new stepwise microtese approach in nonobstructive azoospermia. Eur Urol Suppl 4(8):148
doi: 10.1016/S1569-9056(09)60118-4
Ramasamy R, Yagan N, Schlegel PN (2005) Structural and functional changes to the testis after conventional versus microdissection testicular sperm extraction. Urology 65(6):1190–1194
doi: 10.1016/j.urology.2004.12.059
pubmed: 15922422
Comhaire F (2000) Andropause: hormone replacement therapy in the ageing male. Eur Urol 38(6):655–662
doi: 10.1159/000020358
pubmed: 11111180