Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia

Abstract

Purpose: We aimed to present the results of unilateral microscopic testicular sperm extraction (mTESE) in non-obstructive azoospermia (NOA) cases in our clinic and to elucidate the factors affecting mTESE success. Materials and Methods: Our study was prospectively designed and 102 NOA patients were included. Testis volumes, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone (T) levels were measured and genetic evaluations were carried out. We performed mTESE and divided patients into two groups according to sperm extraction results as mTESE is successful (sperm could be found) or failed (sperm could not be found). The two groups were compared in demographic, clinical and histopathological data. Results: Sperm extraction by mTESE was successful in 64 (62.7%) patients. There was no significant difference between two groups in terms of age, infertility times, serum T and PRL levels (p=0.896, p=0.357, p=0.504, p=0.179, respectively). Serum FSH and LH levels were significantly lower, and the mean testis volume was significantly higher in the group that micro-TESE was successful (p=0.004, p=0.001, p=0.029, respectively). Histopathological evaluation revealed a significant difference between hypospermatogenesis, sertoli cell only syndrome (SCOS) and maturation arrest (MA) groups in terms of mTESE success (88.5%, 37.5%, 30%, respectively; p<0.001). Conclusion: Our unilateral mTESE success rate was similar to those performed bilaterally in literature. Besides the multiple predictive factors of mTESE success rate, unilaterally performed mTESE is less invasive procedure preserving the integrity of the contralateral testis and may be advantageous in terms of improving salvage mTESE results.

Keywords

• non-obstructive azoospermia
• micro-tese
• sperm retrieval
• unilateral