Outcomes of microdissection testicular sperm extraction in men with nonobstructive azoospermia due to maturation arrest

The sperm retrieval rate using microdissection testicular sperm extraction in men with maturation arrest is 52%; men with late maturation arrest and higher follicle-stimulating hormone levels have the highest rates.

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Authors

Aaron M. Bernie, M.D., M.P.H., Kalee Shah, B.A., Joshua A. Halpern, M.D., Jason Scovell, B.A., Ranjith Ramasamy, M.D., Brian Robinson, M.D., Peter N. Schlegel, M.D.

Volume 104, Issue 3, Pages 569-573

Abstract

Objective:

To evaluate sperm retrieval in men with nonobstructive azoospermia and maturation arrest (MA) undergoing microdissection testicular sperm extraction (micro-TESE).

Design:

Retrospective chart review.

Setting:

Tertiary referral center.

Patient(s):

Men with nonobstructive azoospermia and MA who underwent micro-TESE.

Intervention(s):

Microdissection TESE.

Main Outcome Measure(s):

Sperm retrieval rate (SRR).

Result(s):

A total of 211 patients (13%) had a histologic finding of MA at the most advanced level. The overall SRR was 52%. A total of 146 patients were classified as having early MA (arrest at the primary spermatocyte stage), and 65 as having late MA (early spermatid stage). The SRR in men with early, vs. late, MA was 40% vs. 78%. Of the 211 men with MA, 51 had diffuse MA (100% of tubules showed MA). The SRR was significantly lower in men with diffuse vs. focal MA (35% vs. 57%). On multivariable analysis, late MA and higher follicle-stimulating hormone levels were positively associated with successful sperm retrieval.

Conclusion(s):

Sperm were successfully identified in up to one half of the men with MA after micro-TESE. Among men with MA, late MA seems to be the best predictor of successful sperm retrieval with micro-TESE.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00388-X/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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