Comparison of microdissection testicular sperm extraction conventional testicular sperm extraction and testicular sperm aspiration for nonobstructive azoospermia A systematic review and meta analysis

Sperm retrieval was higher for microdissection compared with conventional testicular sperm extraction, and was also higher for conventional testicular sperm extraction compared with testicular sperm aspiration.

Like Comment

Authors

Aaron M. Bernie, M.D., M.P.H., Douglas A. Mata, M.D., M.P.H., Ranjith Ramasamy, M.D., Peter N. Schlegel, M.D., F.A.C.S.

Volume 104, Issue 5, Pages 1099-1103

Abstract

Objective:

To investigate the relative differences in outcomes among microdissection testicular sperm extraction (micro-TESE), conventional testicular sperm extraction (cTESE), and testicular sperm aspiration (TESA) in men with nonobstructive azoospermia.

Design:

Systematic review and meta-analysis.

Setting:

A variety of outpatient academic and private urology clinics.

Patients(s):

Men with nonobstructive azoospermia.

Intervention(s):

Micro-TESE, cTESE, or TESA.

Main Outcome Measure(s):

Sperm retrieval (SR).

Result(s):

Fifteen studies with a total of 1,890 patients were identified. The weighted average age of the patients was 34.4 years, the follicular stimulating hormone level was 20.5 mIU/mL, the T was 373 ng/dL, and the testicular volume was 13.5 mL. In a direct comparison, performance of micro-TESE was 1.5 times more likely (95% confidence interval 1.4–1.6) to result in successful SR as compared with cTESE. Similarly, in a direct comparison, performance of cTESE was 2.0 times more likely (95% confidence interval 1.8–2.2) to result in successful SR as compared with TESA. Because of inconsistent reporting, evaluation of other procedural characteristics and pregnancy outcomes was not possible.

Conclusion(s):

Sperm retrieval was higher for micro-TESE compared with cTESE and for cTESE compared with TESA. Standardization of reported outcomes as well as combining all available SR data would help to further elucidate the SRs of these procedures.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)01647-7/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.

No comments yet.