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%.


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



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


Retrospective cohort study.


Tertiary referral center.


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



Main Outcome Measure(s):

Sperm retrieval rates.


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