MICROSCOPIC TESTICULAR SPERM EXTRACTION

IN PATIENTS OF NON-OBSTRUCTIVE AZOOSPERMIA WITH HISTPATHOLOGIC, CYTOGENETIC AND HORMONAL VARIATIONS.

Authors

  • Maher Saleh Moazin King Fahd Medical City, Riyadh Saudi Arabia.
  • Muhammad Tahir Bashir Malik University Medical & Dental College, Madina Teaching Hospital, Faisalabad.
  • Muhammad Aslam King Fahd Medical City, Riyadh Saudi Arabia
  • Naif Aldaham King Fahd Medical City, Riyadh Saudi Arabia.
  • Muhammad Yahya Alrawi King Fahd Medical City, Riyadh Saudi Arabia.

DOI:

https://doi.org/10.29309/TPMJ/2018.25.02.439

Keywords:

Azoospermia, Infertility, Microscopic Testicular Sperm Extraction, Cytogenetics, Surgical Sperm Retrieval, Assisted Reproductive Techniques

Abstract

Azoospermia, the complete absence of sperms in the ejaculate is found in 1% of
normal males and 10-15% of infertile couples. Surgical sperm retrieval (SSR) and use of sperms
for ICSI/IVF offers an opportunity of parenting to the male factor infertile couples. Micro-TESE
gives higher surgical sperms retrieval rates in those patients in whom the chances of sperm
retrieval otherwise are very low. Objectives: To evaluate the outcome of Microscopic Testicular
Sperm Extraction (Micro-TESE) in different patients groups of non-obstructive azoospermia,
in terms of testicular volume, histopathology, hormones levels as well as cytogenetic variants.
Study Design: Retrospectively reviewed. Setting: Urology Division, King Fahd Medical City,
Riyadh in collaboration with King Abdullah Reproductive Medical Unit (RMU). Period: January
2011 to January 2016. Material & Methods: Fifty-four patients of primary and secondary infertility
age range of 29 to 65 years who had undergone Microscopic Testicular Sperm Extraction
(Micro-TESE). Outcome measures: Finding of sperm in testicular specimen extracted by
microscopic testicular dissection. Results: Out of 54 patients, hormonal abnormalities were
found in 45% patients and 65% had low volume testes. Abnormal histology was found in 23%
patients and 9% had chromosomal abnormalities. Overall sperm retrieval rate in all groups was
33%. Sperm retrieval rate was 34 % in patients with small volume testes (<15ml), 42% patients
with abnormal hormones (FSH), 33% patients with abnormal histology and 38% in patients
with chromosomal abnormalities. Minor complications (small hematoma and orchalgia) were
observed in two (3.7%) patients. Conclusion: Micro-TESE is a valid option for sperm retrieval in
patients in which probability of sperm retrieval is otherwise very low.

Author Biographies

Maher Saleh Moazin, King Fahd Medical City, Riyadh Saudi Arabia.

MD, FRCSC, FEBU
Consultant Urologist,

Muhammad Tahir Bashir Malik, University Medical & Dental College, Madina Teaching Hospital, Faisalabad.

FACS, FCPS, FRCSEd
Ex. Assistant
Consultant Urologist
King Fahd Medical City,
Riyadh Saudi Arabia
Assistant Prof. Urology,

Muhammad Aslam, King Fahd Medical City, Riyadh Saudi Arabia

MD, FRCS
Consultant Urologist

Naif Aldaham, King Fahd Medical City, Riyadh Saudi Arabia.

MD, Saudi Board in Urology
Urology Fellow,

Muhammad Yahya Alrawi, King Fahd Medical City, Riyadh Saudi Arabia.

Senior Embryologist
Reproductive Medical Unit,

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Published

2018-02-10