Microdissection testicular sperm extraction in men with Sertoli cell–only testicular histology

Diagnostic testis biopsy in nonobstructive azoospermia has little value, even when uniform Sertoli cell–only pattern is seen. When both testis volume and follicle-stimulating hormone are considered, sperm retrieval rates are 7%–45%.

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Authors

Boback M. Berookhim, M.D., M.B.A., Gianpiero D Palermo, M.D., Ph.D., Nikica Zaninovic, Ph.D., Zev Rosenwaks, M.D., Peter N. Schlegel, M.D.

Volume 102, Issue 5, Pages 1282-1286

Abstract

Objective:

To study the outcomes of microdissection testicular sperm extraction (microTESE) among men with pure Sertoli cell–only histology on diagnostic testicular biopsy.

Design:

Retrospective cohort study.

Setting:

Tertiary referral center.

Patient(s):

Six hundred forty patients with pure Sertoli cell–only histology on testicular biopsy who underwent microTESE by a single surgeon.

Intervention(s):

MicroTESE.

Main Outcome Measure(s):

Sperm retrieval rates.

Result(s):

Overall, 44.5% of patients with Sertoli cell only had sperm retrieved with microTESE. No difference was noted in sperm retrieval rates based on testis volume (≥15 mL vs. <15 mL, 35.3% vs. 46.1%, respectively). Patients with ≥15 mL testicular volume and FSH 10–15 mU/mL had the worst prognosis, with a sperm retrieval rate of 6.7%. Conclusion(s):

Patients with previous testicular biopsy demonstrating Sertoli cell–only histology can be counseled that they have a reasonable likelihood of sperm retrieval with the contemporary delivery of microTESE. Given this finding, the utility of testicular biopsy before microTESE is further questioned.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)02066-4/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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