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Kim, Kim, and Seo: Comparison between Conventional and Microsurgical Testicular Sperm Extraction in Non-obstructive Azoospermia
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(1): 88-91.

Published online: 31 January 2008

DOI: https://doi.org/10.4111/kju.2008.49.1.88

Comparison between Conventional and Microsurgical Testicular Sperm Extraction in Non-obstructive Azoospermia

Kyung Tae Kim, Jong Hyun Kim1, Ju Tae Seo

Department of Urology, Kwandong University College of Medicine, Korea.

1Department of Urology, Mizmedi Hospital, Seoul, Korea.

jtandro@cgh.co.kr

Received 11 September 2007       Accepted 28 November 2007

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

Recovery of the testicular spermatozoa in non-obstructive azoospermic patients after intracytoplasmic sperm injection (ICSI) is a recent advance in the treatment of male infertility. In this study we compared sperm retrieval using microsurgical testicular sperm extraction (TESE) with retrieval by conventional TESE.

Materials and Methods

A total of 450 men with non-obstructive azoospermia were included in the study. 277 of these 450 men underwent conventional TESE (Group 1), and the other 173 patients underwent microsurgical TESE (Group 2). Microsurgical TESE was performed by making multiple incisions in the tunica albuginea under surgical microscopy, with avoiding the underlying testicular artery. The seminiferous tubules that appeared dilated and opaque were harvested. The cases were categorized into three groups, that is, the germ cell aplasia group, the maturation arrest group and the hypospermatogenesis group. The sperm retrieval rates for the patients in the three histopathological categories were compared between the two groups.

Results

The sperm retrieval rate by conventional TESE was 30.7% and it was 31.4% by microsurgical TESE (p=0.938). For the cases of histologically diagnosed germ cell aplasia the retrieval rate was 11.6% and 21.2%, respectively, for group 1 and group 2 (p=0.026). For the cases of maturation arrest the retrieval rate was 24.4% and 26.0%, respectively, for group 1 and group 2 (p=0.884). For the cases of hypospermatogenesis the retrieval rate was 83.0% and 91.3%, respectively, for group 1 and group 2 (p=0.339).

Conclusions

For non-obstructive patients, and especially those with germ cell aplasia, microsurgical TESE can effectively retrieve spermatozoa and minimize the risk of complication.

Keywords: Azoospermia, Spermatozoa, Sperm retrieval

Figures and Tables

Fig. 1
Surgical microscopy during microsurgical testicular sperm extraction (TESE) in patients with germ cell aplasia shows the indicating dilated, opaque seminiferous tubules (arrow) surrounded by shrunken tubules or fibrotic tissue. Reduced from ×25.
kju-49-88-g001
Table 1
Sperm retrieval rates in relation to various histopathological abnormalities
kju-49-88-i001

TESE: testicular sperm extraction

References

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