Factors Affecting Outcomes of Salvage Micro Testicular Sperm Extraction Following a Failed Testicular Sperm Extraction

Abstract

Aim:To investigate the likelihood of sperm retrieval in repeated micro-testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients.Methods:Data of 310 patients, who underwent a micro-TESE procedure at a center experienced in in vitro fertilization between January 2015 and July 2019, was evaluated retrospectively. Seventy-three patients who had a previous failed sperm retrieval procedure (33 micro-TESE, and 40 TESE) were included in the study. The patients were divided into two groups (group 1: successful, group 2: failure) according to sperm retrieval in salvage micro-TESE. The groups were compared in terms of demographic characteristics and hormonal and histological features.Results:The mean age of the patients was 36.71±8.1 (25-45) years and duration of infertility was 59.45±21.4 (22-247) months. The sperm retrieval rate in patients who underwent salvage micro-TESE was 36.99% (27/73). Sperm retrieval rates were 8/43, 8/16 and 11/14 for patients diagnosed with Sertoli Cell-only syndrome (SCOS), maturation arrest and hypospermatogenesis. The rate of patients with SCOS was significantly higher in the failure group (p<0.01).Conclusion:Salvage micro-TESE provides an important opportunity in patients with NOA with a history of unsuccessful micro-TESE. Sertoli cell-only syndrome seems to have a negative effect on the success of the procedure.

Keywords

• azoospermia
• sertoli cell-only syndrome
• spermatozoa
• sperm retrieval