Testicular Fine-Needle Aspiration for Sperm Retrieval in Azoospermia: A Small Step toward the Technical Standardization.
- Author:
Gianmartin CITO
1
;
Maria Elisabetta COCCIA
;
Francesco SESSA
;
Andrea COCCI
;
Pierangelo VERRIENTI
;
Rita PICONE
;
Rossella FUCCI
;
Luciana CRISCUOLI
;
Sergio SERNI
;
Marco CARINI
;
Alessandro NATALI
Author Information
- Publication Type:Original Article
- Keywords: Azoospermia; Biopsy, fine-needle; Infertility, male; Reproductive techniques; Sperm retrieval
- MeSH: Azoospermia*; Biopsy, Fine-Needle*; Butterflies; Cryopreservation; Female; Hematoma; Humans; Infertility, Male; Intraoperative Complications; Male; Needles; Operative Time; Ovulation Induction; Prospective Studies; Reproductive Techniques; Reproductive Techniques, Assisted; Sperm Injections, Intracytoplasmic; Sperm Motility; Sperm Retrieval*; Spermatozoa*; Syringes
- From:The World Journal of Men's Health 2019;37(1):55-67
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The aim was to describe our preliminary experience performing testicular fine-needle aspiration (TEFNA) with a larger needle in infertile patients with obstructive azoospermia, and to provide a systematic literature review of the different testicular sperm aspiration techniques, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. MATERIALS AND METHODS: We prospectively collected data between March 2017 and June 2018. All men underwent bilateral TEFNA under analgo-sedation, using a larger disposable 18-gauge butterfly needle with 60 mL Luer-Lock syringe attached to it. RESULTS: Thirty consecutive patients were enrolled. Median operative time was 16 minutes (interquartile range [IQR]: 12–30 minutes). No intraoperative complications occurred. Two/thirty patients (6.7%) reported postoperative adverse events: 1 patient had prolonged orchialgia, 1 patient presented scrotal hematoma. Successful sperm retrieval was found in 28/30 cases (93.3%). Median sperm concentration was 0.05 ×106/mL (IQR: 0.001–0.1 ×106/mL). Median total sperm motility was 10% (IQR: 0%–15%). In 20/30 men (66.7%) sperm retrieved was used for fresh intracytoplasmic sperm injection cycle, in 8/30 (26.7%) sperm cryopreservation was necessary, because on the day of sperm retrieval the female resulted not responder to ovarian stimulation. In this cases mean number of 3 (IQR: 1–4) bio system straws was cryopreserved. CONCLUSIONS: TEFNA with 18-gauge needle proved to be a feasible, safe and effective treatment, even if future prospective studies will be addressed to clarify what type of azoospermia benefits from this procedure, and if a larger needle permits to improve Assisted Reproductive Technologies (ART) outcomes.
