Modified stepwise mini-incision microdissection testicular sperm extraction: a useful technique for patients with a history of orchidopexy affected by non-obstructive azoospermia.

Peng LI; Chen-Cheng YAO; Er-Lei ZHI; Yuan XU; Zhong WAN; Ying-Chuan JIANG; Yu-Hua HUANG; Yue-Hua GONG; Hui-Xing CHEN; Ru-Hui TIAN; Chao YANG; Liang-Yu ZHAO; Zheng LI

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Modified stepwise mini-incision microdissection testicular sperm extraction: a useful technique for patients with a history of orchidopexy affected by non-obstructive azoospermia.

Author: Peng LI ¹ ; Chen-Cheng YAO ¹ ; Er-Lei ZHI ¹ ; Yuan XU ² ; Zhong WAN ¹ ; Ying-Chuan JIANG ¹ ; Yu-Hua HUANG ¹ ; Yue-Hua GONG ¹ ; Hui-Xing CHEN ¹ ; Ru-Hui TIAN ¹ ; Chao YANG ¹ ; Liang-Yu ZHAO ¹ ; Zheng LI ¹
Author Information

1. Department of Andrology, Center for Men's Health, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.
2. Reproductive Medicine Center, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.
Publication Type:Journal Article
Keywords: Non-obstructive azoospermia; Microdissection testicular sperm extraction; Orchidopexy; Cryptorchidism
MeSH: Adult; Azoospermia/surgery*; Humans; Male; Microdissection/methods*; Middle Aged; Orchiopexy; Retrospective Studies; Sperm Retrieval
From: Journal of Zhejiang University. Science. B 2020;21(1):87-92
CountryChina
Language:English
Abstract: Non-obstructive azoospermia (NOA), which is defined as the absence of spermatozoa in the ejaculate secondary to impaired spermatogenesis within the testis, may be caused by a variety of etiologies, including varicocele-induced testicular damage, cryptorchidism, prior testicular torsion, post-pubertal mumps orchitis, gonadotoxic effects from medications, genetic abnormalities, chemotherapy/radiation, and other unknown causes currently classified as idiopathic (Cocuzza et al., 2013). The microdissection testicular sperm extraction (micro-TESE) technique involves a meticulous microsurgical exploration of the testicular parenchyma to identify and selectively extract larger seminiferous tubules that carry a higher probability of complete spermatogenesis (Schlegel, 1999). The Cornell group evaluated the efficacy of micro-TESE in 152 NOA patients with an associated history of cryptorchidism. In their series, spermatozoa were successfully retrieved in 116/181 attempts (64%), and the resulting pregnancy rate was 50% with a delivery rate of 38% (Dabaja and Schlegel, 2013). Franco et al. (2016) described a stepwise micro-TESE approach in NOA patients, which was considered to reduce the cost, time, and effort associated with the surgery. Alrabeeah et al. (2016) further reported that a mini-incision micro-TESE, carried through a 1-cm equatorial testicular incision, can be useful for micro-TESE candidates, particularly in patients with cryptozoospermia. We conducted a retrospective study of 20 consecutive NOA patients with a history of orchidopexy from May 2015 to March 2017.