Is ex vivo microdissection testicular sperm extraction indicated for infertile men undergoing radical orchiectomy for testicular cancer Case report and literature review

Areas of spermatogenesis may be missed with conventional testicular sperm extraction (TESE) in azoospermic men with testicular cancer. Microdissection TESE should be offered at orchiectomy to maximize sperm retrieval.

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Authors

Nicholas Haddad, M.Sc., Khalid Al-Rabeeah, M.D., Ronald Onerheim, M.D., Armand Zini, M.D.

Volume 101, Issue 4, Pages 956-959

Abstract

Objective:

To report a case of an infertile man with nonobstructive azoospermia who underwent simultaneous radical orchiectomy for testicular cancer and testicular sperm extraction (TESE) for preservation of fertility.

Design:

Case report and literature review.

Setting:

University teaching hospital.

Patient(s):

A couple being treated for infertility.

Intervention(s):

Radical orchiectomy with simultaneous TESE.

Main Outcome Measure(s):

Sperm retrieval, histologic evaluation of archived testicular pathology slides.

Result(s):

We retrieved 20 spermatozoa from the multiple random TESE samples obtained at radical orchiectomy. Histologic evaluation of the archived testicular pathology slides revealed that the testis contained several foci of active spermatogenesis, suggesting that a significantly greater number of spermatozoa would likely have been retrieved had a microdissection TESE been performed instead of the multiple TESEs.

Conclusion(s):

We propose that microdissection TESE should be considered the preferred sperm retrieval technique at the time of radical orchiectomy in men with coexistent nonobstructive azoospermia and testicular cancer.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)03488-2/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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