Long Term Effects of Micro-surgical Testicular Sperm Extraction on Androgen Status in Patients with Non Obstructive Azoospermia

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2006 Mar 22

PMID 16549019

Citations 16

Authors

Karel Everaert

Ilse De Croo

Wim Kerckhaert

Peter Dekuyper

Marc Dhont

Josiane Van der Elst

Petra De Sutter

Frank Comhaire

Ahmed Mahmoud

Nicolaas Lumen

Affiliations

Soon will be listed here.

Abstract

Background: The aim of our study was to review the results of microsurgically performed testicular sperm extraction (TESE) and to evaluate its possible long term effects on serum testosterone (T).

Methods: We operated on 48 men (35 +/- 8 years) with non-obstructive azoospermia (NOA). If no spermatozoa were found following a micro epididymal sperm extraction (Silber et al., 1994) and testicular biopsy, testicular microdissection was performed or multiple microsurgical testicular biopsies were taken. The mean follow-up of the serum T was 2.4 +/- 1.1 years.

Results: Sperm was retrieved in 17/48 (35%) of the men. The per couple take home baby rate if sperm was retrieved was 4/17 (24%). Serum T decreased significantly at follow-up (p < 0.05) and 5/31 (16%) de novo androgen deficiencies developed

Conclusion: In patients with non-obstructive azoospermia in whom no spermatozoa were found following a micro epididymal sperm aspiration and a simple testicular biopsy, we were able to retrieve spermatozoa in 35% of the men. The take home baby rate was 24% among couples with spermatozoa present upon TESE. De novo androgen deficiency occurred in 16% of the male patients following TESE indicating that, in men with NOA, long term hormonal follow up is recommended after TESE.

Citing Articles

Testicular mapping-guided sperm retrieval upfront microTESE in non-obstructive azoospermia: a comparison of sperm retrieval, pregnancy and live-birth rates.

Kapadia A, Greear G, Chen T, Ball D, McClure R, Ostrowski K Transl Androl Urol. 2025; 13(12):2672-2680.

PMID: 39816230 PMC: 11732293. DOI: 10.21037/tau-24-362.

Micromapping testicular sperm extraction: A new technique for microscopic testicular sperm extraction in nonobstructive azoospermia.

Tai T, Miyamoto W, Fukuoka Y, Shibasaki S, Takahashi M, Okuyama N Reprod Med Biol. 2024; 23(1):e12566.

PMID: 38476958 PMC: 10927935. DOI: 10.1002/rmb2.12566.

Comparison of sperm retrieval rate between superficial and deep dissection during microscopic testicular sperm extraction.

Mandourah H, Alghafees M, Alali H, Alsuhaibani S, Gutub E, Aldosari L Urol Ann. 2024; 16(1):108-112.

PMID: 38415231 PMC: 10896327. DOI: 10.4103/ua.ua_22_23.

How Successful Is Surgical Sperm Retrieval in Klinefelter Syndrome?.

Kailash Y, Raheem A, Homa S Front Reprod Health. 2022; 3:636629.

PMID: 36303963 PMC: 9580639. DOI: 10.3389/frph.2021.636629.

Development and validation predictive models of sperm retrieval for azoospermic men undergoing testicular sperm aspiration: a multicentre, retrospective, cohort study.

Li J, Du C, Liu Z, Zhang F, Li L, Wu J J Assist Reprod Genet. 2022; 39(8):1779-1787.

PMID: 35870097 PMC: 9428087. DOI: 10.1007/s10815-022-02531-y.

References

Schlegel P . Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod. 1999; 14(1):131-5. DOI: 10.1093/humrep/14.1.131. View

Comhaire F . Andropause: hormone replacement therapy in the ageing male. Eur Urol. 2000; 38(6):655-62. DOI: 10.1159/000020358. View

Westlander G, Ekerhovd E, Granberg S, Lycke N, Nilsson L, Werner C . Serial ultrasonography, hormonal profile and antisperm antibody response after testicular sperm aspiration. Hum Reprod. 2001; 16(12):2621-7. DOI: 10.1093/humrep/16.12.2621. View

Bouloux P, Warne D, Loumaye E . Efficacy and safety of recombinant human follicle-stimulating hormone in men with isolated hypogonadotropic hypogonadism. Fertil Steril. 2002; 77(2):270-3. DOI: 10.1016/s0015-0282(01)02973-9. View

Schill T, Bals-Pratsch M, Kupker W, Sandmann J, Johannisson R, Diedrich K . Clinical and endocrine follow-up of patients after testicular sperm extraction. Fertil Steril. 2003; 79(2):281-6. DOI: 10.1016/s0015-0282(02)04663-0. View

De Sutter P, Van der Elst J, Coetsier T, Dhont M . Single embryo transfer and multiple pregnancy rate reduction in IVF/ICSI: a 5-year appraisal. Reprod Biomed Online. 2003; 6(4):464-9. DOI: 10.1016/s1472-6483(10)62169-4. View

Hibi H, Taki T, Yamada Y, Honda N, Fukatsu H, Yamamoto M . Testicular sperm extraction using microdissection for non-obstructive azoospermia. Reprod Med Biol. 2018; 1(1):31-34. PMC: 5906840. DOI: 10.1046/j.1445-5781.2002.00006.x. View

JOHNSEN S . Testicular biopsy score count--a method for registration of spermatogenesis in human testes: normal values and results in 335 hypogonadal males. Hormones. 1970; 1(1):2-25. DOI: 10.1159/000178170. View

Devroey P, Liu J, Nagy Z, Goossens A, Tournaye H, Camus M . Pregnancies after testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermia. Hum Reprod. 1995; 10(6):1457-60. DOI: 10.1093/humrep/10.6.1457. View

10.

Craft I, Bennett V, Nicholson N . Fertilising ability of testicular spermatozoa. Lancet. 1993; 342(8875):864. DOI: 10.1016/0140-6736(93)92722-6. View

11.

Jow W, Steckel J, Schlegel P, Magid M, Goldstein M . Motile sperm in human testis biopsy specimens. J Androl. 1993; 14(3):194-8. View

12.

Schoysman R, Vanderzwalmen P, Nijs M, Van De Casseye M . Successful fertilization by testicular spermatozoa in an in-vitro fertilization programme. Hum Reprod. 1993; 8(8):1339-40. DOI: 10.1093/oxfordjournals.humrep.a138254. View

13.

Silber S, Nagy Z, Liu J, Tournaye H, Lissens W, Ferec C . The use of epididymal and testicular spermatozoa for intracytoplasmic sperm injection: the genetic implications for male infertility. Hum Reprod. 1995; 10(8):2031-43. DOI: 10.1093/oxfordjournals.humrep.a136231. View

14.

Kahraman S, Ozgur S, Alatas C, Aksoy S, Tasdemir M, Nuhoglu A . Fertility with testicular sperm extraction and intracytoplasmic sperm injection in non-obstructive azoospermic men. Hum Reprod. 1996; 11(4):756-60. DOI: 10.1093/oxfordjournals.humrep.a019249. View

15.

Schlegel P, Palermo G, Goldstein M, Menendez S, Zaninovic N, Veeck L . Testicular sperm extraction with intracytoplasmic sperm injection for nonobstructive azoospermia. Urology. 1997; 49(3):435-40. DOI: 10.1016/S0090-4295(97)00032-0. View

16.

Friedler S, Raziel A, Strassburger D, Soffer Y, Komarovsky D, Ron-El R . Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Reprod. 1997; 12(7):1488-93. DOI: 10.1093/humrep/12.7.1488. View

17.

Coetsier T, Verhoeff A, De Sutter P, Roest J, Dhont M . Transport-in-vitro fertilization/intracellular sperm injection: a prospective randomized study. Hum Reprod. 1997; 12(8):1654-6. DOI: 10.1093/humrep/12.8.1654. View

18.

Schlegel P, Su L . Physiological consequences of testicular sperm extraction. Hum Reprod. 1997; 12(8):1688-92. DOI: 10.1093/humrep/12.8.1688. View

19.

Silber S, Nagy Z, Devroey P, Tournaye H, van Steirteghem A . Distribution of spermatogenesis in the testicles of azoospermic men: the presence or absence of spermatids in the testes of men with germinal failure. Hum Reprod. 1998; 12(11):2422-8. DOI: 10.1093/humrep/12.11.2422. View

20.

ROSENLUND B, Kvist U, Ploen L, Rozell B, Sjoblom P, Hillensjo T . A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod. 1998; 13(5):1266-71. DOI: 10.1093/humrep/13.5.1266. View