Prognostic Factors for Successful Microdissection Testicular Sperm Extraction (Micro-TESE)
Mohamed Hamdy Mashaly *
Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tarek Ahmed Gamil
Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Maged Moustafa Ragab
Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Mohamed Abo El-Enen Ghalwash
Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the causes of infertility, these men need sperm retrieval from testes like microdissection testicular sperm extraction (Micro-TESE). This work aims to assess the different preoperative and intraoperative factors that predict successful sperm retrieval with Microdissection Testicular Sperm Extraction (Micro-TESE) in men with non-obstructive azoospermia.
Methods: Our study is a cohort prospective one, conducted on 52 male patients with non-obstructive azoospermia who attended to the outpatient andrology and infertility clinic of Urology Department, Tanta University Hospitals during the period between December2018 to November2019. All patients were subjected to detailed medical history, physical examination, two semen analysis on two different laboratories. Microdissection Testicular Sperm Extraction is performed to all patients after Estimation of serum FSH, LH, testosterone, prolactin, estradiol and scrotal Doppler ultrasonography
Results: From 52 patients who have done, Patients were divided in to 2 groups according to the result of Micro-TESE procedure: negative SSR group (28 patients) and positive SSR group (24 patients).In comparison between the two groups according to preoperative factors as age, FSH, LH, estradiol, testosterone, prolactin and testicular volume, there was no significant difference between these groups. On comparison of intraoperative size of seminiferous tubules in relation to results of Micro-TESE, we found that presence of large convoluted seminiferous tubules was statistically significant in prediction of successful sperm retrieval with Micro-TESE
Conclusions: The chances of sperm retrieval in men with NOA by Micro-TESE are not related to preoperatively age, FSH, LH, testosterone, estradiol, prolactin and testicular volume. The detection of large seminiferous tubules intraoperatively is a good predictor for successful sperm retrieval with Micro-TESE as it was statistically significant.
Keywords: Infertility, non-obstructive azoospermia, Microdissection testicular sperm extraction, Micro-TESE, surgical sperm retrieval