Conventional testicular sperm extraction (TESE) and non-obstructive azoospermia: is there still a chance in the era of microdissection TESE? Results from a single non-academic community hospital

被引：23

作者：

Sacca, A. ^{[1
]}

Pastore, A. L. ^{[2
]}

Roscigno, M. ^{[1
]}

Naspro, R. ^{[1
]}

Pellucchi, F. ^{[1
]}

Fuschi, A. ^{[2
]}

Maruccia, S. ^{[3
]}

Territo, A. ^{[4
]}

Pisano, F. ^{[5
]}

Zanga, L. ^{[6
]}

Capitanio, E. ^{[6
]}

Carbone, A. ^{[2
]}

Fusi, F. ^{[6
]}

Chinaglia, D. ^{[7
]}

Da Pozzo, L. F. ^{[1
]}

机构：

[1] ASST Papa Giovanni XXIII, Dept Urol, Bergamo, Italy

[2] Univ Roma La Sapienza, Fac Pharm & Med, Urol Unit, Dept Med Surg Sci & Biotechnol, Latina, Italy

[3] IRCSS Policlin San Donato, Dept Urol, Milan, Italy

[4] Univ Modena & Reggio Emilia, Dept Urol, Modena, Italy

[5] Univ Turin, Dept Urol, AO Citta Salute & Sci, Turin, Italy

[6] ASST Papa Giovanni XXIII, Dept Maternal & Pediat, USSD Ctr PMA, Bergamo, Italy

[7] ASST Papa Giovanni XXIII, Dept Pathol, Bergamo, Italy

来源：

ANDROLOGY | 2016年 / 4卷 / 03期

关键词：

infertility; non-obstructive azoospermia; spermatozoa retrieval; testicular sperm extraction; INHIBIN-B; NEEDLE BIOPSIES; MEN; INJECTION; RETRIEVAL; SPERMATOGENESIS; HISTOLOGY; ASPIRATION; MULTIPLE; TESTES;

D O I：

10.1111/andr.12159

中图分类号：

R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

摘要：

Spermatozoa can be retrieved in non-obstructive azoospermia (NOA) patients despite the absence of ejaculated spermatozoa in their semen because of the presence of isolated foci with active spermatogenesis. Conventional testicular sperm extraction (c-TESE) in patients with NOA has been partially replaced by micro-TESE. It is still under debate the problem regarding the higher costs related to micro-TESE when compared with c-TESE. In this study, we evaluated sperm retrieval rate (SRR) of c-TESE in naive NOA patients. Sixty-three NOA patients were referred to our centre for a c-TESE. For every subject, we collected demographic data, cause of infertility, time to first infertility diagnosis, serum levels of LH, FSH, total testosterone and prolactin. A statistical analysis was conducted to correlate all the clinical variables, the histology and the Johnsen score with the SRR. Sixty-three consecutive NOA patients with a mean age of 37.3years were included. The positive SRR was 47.6%. No statistical differences were observed between positive vs. negative SRR regarding mean FSH (17.12 vs. 19.03 mUI/mL; p=0.72), and LH (9.72 vs. 6.92 mUI/mL; p=0.39) values. Interestingly, we found a statistically significant difference in terms of time to first infertility diagnosis (+SRR vs. -SRR; 44.5 vs. 57months; p=0.02) and regarding to age (+SSR vs. -SRR; 40.1 vs. 35.3; p=0.04). There was a statistically significant decrease in SRRs with the decline in testicular histopathology from hypospermatogenesis to maturation arrest, and SCO. The mean Johnsen score was 5.9 with a mean percentage of Johnsen score 8 tubules equal to 19%. The overall pregnancy rate was 26.6%. In our prospective cohort of patients successful SRR with c-TESE was 47.6%. Lower costs and high reproducibility of this technique still support this procedure as an actual reliable option in NOA patients for sperm retrieval.

引用

页码：425 / 429

页数：5

共 38 条

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