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Volume 15, Issue 6 (November 2013) 15, 795–798; 10.1038/aja.2013.98
No relationship between biopsy sites near the main testicular vessels or rete testis and successful sperm retrieval using conventional or microdissection biopsies in 220 non-obstructive azoospermic men
J Ullrich Schwarzer1, Heiko Steinfatt1, Manfred Schleyer2, Frank M Köhn3, Klaus Fiedler2, Irene von Hertwig2, Gottfried Krüsmann2 and Wolfgang Würfel2
1Andrologie Centrum München, München D-81241, Germany
2Kinderwunsch Centrum München, München D-81241, Germany
3Andrologicum München, München D-80331, Germany
Correspondence: Dr JU Schwarzer, (schwarzer@andromuc.de)
Received 15 April 2013; Revised 30 June 2013; Accepted 4 July 2013 Advance online publication 9 September 2013
| Abstract |
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In 220 consecutive patients with non-obstructive azoospermia, sperm retrieval was attempted by a combination of conventional and microdissection testicular sperm extraction (TESE). For sperm retrieval, 2–3 conventional biopsies were performed followed by a microdissection TESE in cases of negative conventional biopsies. During the surgery, the vasculature of the testis was assessed using the operative microscope, and the location of positive biopsies was registered in relation to the blood supply. The overall sperm retrieval rate was 58.2%. From the initial conventional biopsies, sperm could be retrieved in 46.8% of the patients. With microdissection TESE, sperm could be retrieved from an additional 11.4% of the patients. The further use of microdissection TESE improved the sperm retrieval rate significantly (P=0.017). No significant accumulation of positive biopsies was found towards the rete testis or the main testicular vessels.
Keywords: intracytoplasmic sperm injection; male infertility; microdissection testicular sperm extraction; non-obstructive azoospermia; sperm retrieval
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