Efficacy of the second micro–testicular sperm extraction after failed first micro–testicular sperm extraction in men with nonobstructive azoospermia

On the basis of our results, 18.4% of men with failed first microsurgical–testicular sperm extraction had a probability of sperm retrieval with the second microsurgical–testicular sperm extraction.

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VOLUME 115, ISSUE 4, P915-921

Authors:

Oktay Özman, M.D., Süleyman Tosun, M.D., Numan Bayazıt, M.D., Sami Cengiz, M.D., Mustafa Emre Bakırcıoğlu, M.D. 

Abstract:

Objective

To evaluate the efficacy of the second micro–testicular sperm extraction (TESE)in men with nonobstructive azoospermia in whom the first micro-TESE failed.


Design

Retrospective.


Setting

Private clinic.


Patient(s)

One hundred twenty-five men with nonobstructive azoospermia with failed previous micro-TESE. The patients were divided into 2 groups according to their surgical sperm retrieval status during the second micro-TESE. If sperm could not be found, these patients were classified as Group 1, and, if sperm was found, the patients were classified as Group 2. The 2 groups were compared for clinical parameters and pathologic findings.


Intervention(s)

Micro-TESE.


Main Outcome Measure(s)

Surgical sperm retrieval status.


Result(s)

Sperm was recovered successfully in 23 of 125 (18.4%) men with the second micro-TESE. Testicular volume was significantly lower in Group 2 (8.2 ± 5.4 mL) than Group 1 (11.3 ± 5.3 mL). Seven of 14 (50%) patients with Klinefelter’s Syndrome had sperm recovery with repeat micro-TESE. The sperm retrieval rate was significantly higher in the Leydig cell hyperplasia and tubular sclerosis groups than in the Sertoli cell only and maturation arrest groups (54.5%, 10.1%, and 18.6%, respectively).


Conclusion(s)

On the basis of our results, 18.4% of men with failed first micro-TESE had a probability of sperm retrieval with the second micro-TESE. Patients with successful sperm recovery had smaller testicular volumes than those with a failed second attempt. Severe testicular atrophy was not a contraindication for the second micro-TESE in such patients.

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.