Mini‐incision microdissection testicular sperm extraction: a useful technique for men with cryptozoospermia. (6th January 2016)

• Record Type: Journal Article
• Authors: Alrabeeah, K.; Witmer, J.; Ruiz, S.; AlMalki, A.; Phillips, S.; Zini, A.
• Is Part Of: Andrology. Volume 4:Number 2(2016:Mar.)
• Page Start: 284
• Page End: 289
• Publication Date: 2016-01-06
• Subjects: infertility -- microsurgery -- spermatozoa -- testis -- azoospermia; Andrology -- Periodicals; 616.65
• DOI: 10.1111/andr.12152
• Languages: English
• ISSNs: 2047-2919

Abstract

Summary: Microdissection testicular sperm extraction (micro‐TESE) was developed to minimize the testicular injury associated with multiple open TESEs. We sought to evaluate a mini‐incision micro‐TESE in men with cryptozoospermia and non‐obstructive azoospermia (NOA). We conducted a retrospective study of 26 consecutive men with NOA and cryptozoospermia who underwent a primary (first) micro‐TESE between March 2015 and August 2015. Final assessment of sperm recovery (reported on the day of intra‐cytoplasmic sperm injection (ICSI)) was recorded as (i) successful (available spermatozoa for ICSI) or (ii) unsuccessful (no spermatozoa for ICSI). The decision to perform a mini‐incision micro‐TESE (with limited unilateral micro‐dissection) or standard/extensive (with unilateral or bilateral micro‐dissection) was guided by the intra‐operative identification of sperm recovery (≥5 spermatozoa) from the first testicle. Overall, sperm recovery was successful in 77% (20/26) of the men. In 37% of the men (8/26), the mini‐incision micro‐TESE was successful (positive sperm recovery). The remaining 18 men required a standard (extensive) microdissection: 61% (11/18) underwent a unilateral and 39% (7/18) a bilateral micro‐TESE. We found that 90% (9/10) of the men with cryptozoospermia and 63% (10/16) of the men with NOA underwent a unilateral (mini or standard micro‐TESE). The mini‐incision micro‐TESE allowed for successful sperm recovery in 60% (6/10) of the men with cryptozoospermia and 13% (2/16) of the men with NOA. The data demonstrate that a mini‐incision micro‐TESE together with rapid intra‐operative assessment and identification of spermatozoa recovery can be useful in men undergoing microTESE, particularly, men with cryptozoospermia.