Microdissection Testicular Sperm Extraction

Effect of Prior Biopsy on Success of Sperm Retrieval

Ranjith Ramasamy, Peter N. Schlegel

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Purpose: We determined the effect of prior biopsies with no sperm seen on the chance of sperm retrieval with microdissection testicular sperm extraction in men with nonobstructive azoospermia. Materials and Methods: A total of 311 men with NOA underwent microdissection testicular sperm extraction. Of these patients 135 underwent no prior biopsies, 159 underwent 1 or 2 diagnostic testicular biopsies per testis and 17 underwent 3 or 4. The outcome measure studied was the success of sperm retrieval with microdissection testicular sperm extraction. Serum follicle-stimulating hormone and histopathological diagnosis were examined as predictive factors for sperm recovery. Results: Spermatozoa were retrieved in 150 men by microdissection testicular sperm extraction (48%). The success of sperm retrieval in patients who underwent 3 to 4 biopsies (23%) was lower than the retrieval rate in patients who underwent no prior biopsies (56%) and 1 to 2 biopsies per testis (51%) (p = 0.04). When histopathology was considered, patients with Sertoli-cell-only diagnosis on prior diagnostic biopsy had lower retrieval rates compared to the group with no biopsies (p = 0.02). Men with maturation arrest and hypospermatogenesis had similar microdissection testicular sperm extraction sperm retrieval rates regardless of the number of prior biopsies. Spermatozoa recovery was independent of serum follicle-stimulating hormone. Conclusions: There is no threshold of prior negative biopsies that precludes the success of sperm retrieval using microdissection testicular sperm extraction. A limited number of testicular biopsies provide limited or no prognostic value for sperm retrieval with microdissection testicular sperm extraction.

Original languageEnglish (US)
Pages (from-to)1447-1449
Number of pages3
JournalJournal of Urology
Volume177
Issue number4
DOIs
StatePublished - Apr 2007
Externally publishedYes

Fingerprint

Sperm Retrieval
Microdissection
Spermatozoa
Biopsy
Follicle Stimulating Hormone
Testis
Oligospermia
Sertoli Cells
Serum

Keywords

  • anatomy and histology
  • azoospermia
  • biopsy
  • infertility
  • male
  • testis

ASJC Scopus subject areas

  • Urology

Cite this

Microdissection Testicular Sperm Extraction : Effect of Prior Biopsy on Success of Sperm Retrieval. / Ramasamy, Ranjith; Schlegel, Peter N.

In: Journal of Urology, Vol. 177, No. 4, 04.2007, p. 1447-1449.

Research output: Contribution to journalArticle

@article{7a382b3d0a3341cfaf78323e912106aa,
title = "Microdissection Testicular Sperm Extraction: Effect of Prior Biopsy on Success of Sperm Retrieval",
abstract = "Purpose: We determined the effect of prior biopsies with no sperm seen on the chance of sperm retrieval with microdissection testicular sperm extraction in men with nonobstructive azoospermia. Materials and Methods: A total of 311 men with NOA underwent microdissection testicular sperm extraction. Of these patients 135 underwent no prior biopsies, 159 underwent 1 or 2 diagnostic testicular biopsies per testis and 17 underwent 3 or 4. The outcome measure studied was the success of sperm retrieval with microdissection testicular sperm extraction. Serum follicle-stimulating hormone and histopathological diagnosis were examined as predictive factors for sperm recovery. Results: Spermatozoa were retrieved in 150 men by microdissection testicular sperm extraction (48{\%}). The success of sperm retrieval in patients who underwent 3 to 4 biopsies (23{\%}) was lower than the retrieval rate in patients who underwent no prior biopsies (56{\%}) and 1 to 2 biopsies per testis (51{\%}) (p = 0.04). When histopathology was considered, patients with Sertoli-cell-only diagnosis on prior diagnostic biopsy had lower retrieval rates compared to the group with no biopsies (p = 0.02). Men with maturation arrest and hypospermatogenesis had similar microdissection testicular sperm extraction sperm retrieval rates regardless of the number of prior biopsies. Spermatozoa recovery was independent of serum follicle-stimulating hormone. Conclusions: There is no threshold of prior negative biopsies that precludes the success of sperm retrieval using microdissection testicular sperm extraction. A limited number of testicular biopsies provide limited or no prognostic value for sperm retrieval with microdissection testicular sperm extraction.",
keywords = "anatomy and histology, azoospermia, biopsy, infertility, male, testis",
author = "Ranjith Ramasamy and Schlegel, {Peter N.}",
year = "2007",
month = "4",
doi = "10.1016/j.juro.2006.11.039",
language = "English (US)",
volume = "177",
pages = "1447--1449",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Microdissection Testicular Sperm Extraction

T2 - Effect of Prior Biopsy on Success of Sperm Retrieval

AU - Ramasamy, Ranjith

AU - Schlegel, Peter N.

PY - 2007/4

Y1 - 2007/4

N2 - Purpose: We determined the effect of prior biopsies with no sperm seen on the chance of sperm retrieval with microdissection testicular sperm extraction in men with nonobstructive azoospermia. Materials and Methods: A total of 311 men with NOA underwent microdissection testicular sperm extraction. Of these patients 135 underwent no prior biopsies, 159 underwent 1 or 2 diagnostic testicular biopsies per testis and 17 underwent 3 or 4. The outcome measure studied was the success of sperm retrieval with microdissection testicular sperm extraction. Serum follicle-stimulating hormone and histopathological diagnosis were examined as predictive factors for sperm recovery. Results: Spermatozoa were retrieved in 150 men by microdissection testicular sperm extraction (48%). The success of sperm retrieval in patients who underwent 3 to 4 biopsies (23%) was lower than the retrieval rate in patients who underwent no prior biopsies (56%) and 1 to 2 biopsies per testis (51%) (p = 0.04). When histopathology was considered, patients with Sertoli-cell-only diagnosis on prior diagnostic biopsy had lower retrieval rates compared to the group with no biopsies (p = 0.02). Men with maturation arrest and hypospermatogenesis had similar microdissection testicular sperm extraction sperm retrieval rates regardless of the number of prior biopsies. Spermatozoa recovery was independent of serum follicle-stimulating hormone. Conclusions: There is no threshold of prior negative biopsies that precludes the success of sperm retrieval using microdissection testicular sperm extraction. A limited number of testicular biopsies provide limited or no prognostic value for sperm retrieval with microdissection testicular sperm extraction.

AB - Purpose: We determined the effect of prior biopsies with no sperm seen on the chance of sperm retrieval with microdissection testicular sperm extraction in men with nonobstructive azoospermia. Materials and Methods: A total of 311 men with NOA underwent microdissection testicular sperm extraction. Of these patients 135 underwent no prior biopsies, 159 underwent 1 or 2 diagnostic testicular biopsies per testis and 17 underwent 3 or 4. The outcome measure studied was the success of sperm retrieval with microdissection testicular sperm extraction. Serum follicle-stimulating hormone and histopathological diagnosis were examined as predictive factors for sperm recovery. Results: Spermatozoa were retrieved in 150 men by microdissection testicular sperm extraction (48%). The success of sperm retrieval in patients who underwent 3 to 4 biopsies (23%) was lower than the retrieval rate in patients who underwent no prior biopsies (56%) and 1 to 2 biopsies per testis (51%) (p = 0.04). When histopathology was considered, patients with Sertoli-cell-only diagnosis on prior diagnostic biopsy had lower retrieval rates compared to the group with no biopsies (p = 0.02). Men with maturation arrest and hypospermatogenesis had similar microdissection testicular sperm extraction sperm retrieval rates regardless of the number of prior biopsies. Spermatozoa recovery was independent of serum follicle-stimulating hormone. Conclusions: There is no threshold of prior negative biopsies that precludes the success of sperm retrieval using microdissection testicular sperm extraction. A limited number of testicular biopsies provide limited or no prognostic value for sperm retrieval with microdissection testicular sperm extraction.

KW - anatomy and histology

KW - azoospermia

KW - biopsy

KW - infertility

KW - male

KW - testis

UR - http://www.scopus.com/inward/record.url?scp=33947200602&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947200602&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2006.11.039

DO - 10.1016/j.juro.2006.11.039

M3 - Article

VL - 177

SP - 1447

EP - 1449

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4

ER -