Abstract
Objective:To study the outcomes of testicular sperm extraction (TESE) among men with pure Sertoli cell-only histology identified during diagnostic testicular biopsy.Methods:This retrospective cohort study involved 1680 cases of patients with nonobstructive azoospermia (NOA) diagnosed with pure Sertoli cell-only histology who underwent testicular biopsy with TESE in a reference center in Brazil by a single surgeon. Sperm retrieval rates (SSR) were the main outcome measure.Results:Overall, 14.83% of patients with Sertoli cell-only had sperm retrieved with TESE in quantity that allowed the performance of ICSI. No differences were observed in SSR based on testis volume (<15 mL vs. <15 mL) or serum FSH level. Conclusions:Patients with Sertoli cell-only histology can be counseled that they have some likelihood of sperm retrieval with TESE. Based on the findings, patients to be submitted to testicular biopsy for histologic analysis may be concomitantly prepared for ICSI with TESE in case sperm is available.
Highlights
Cases of azoospermia due to spermatogenic failure, or nonobstructive azoospermia (NOA) affects between 1% to 2% of the male population, and around 15% to 20% of men seeking infertility evaluation (Willott, 1982; Jarow et al, 1989)
In this article we report the outcomes of testicular sperm extraction (TESE) obtained from a large cohort of NOA patients with Sertoli cell-only pattern conducted at a reference center in Brazil, with the intention to provide diagnostic and prognostic information
Testicular histology was determined based on results of testicular biopsies during intraoperative testicular exploration performed with TESE
Summary
Cases of azoospermia due to spermatogenic failure, or nonobstructive azoospermia (NOA) affects between 1% to 2% of the male population, and around 15% to 20% of men seeking infertility evaluation (Willott, 1982; Jarow et al, 1989). The establishment of NOA is determined by the absence of spermatozoa in the ejaculate despite the integrity of the spermatic pathway. Until recently, this was reported as an irreversible condition (testicular failure), due to congenital and acquired factors (Willott, 1982). With the advent of intracytoplasmic sperm injection (ICSI), the surgical sperm retrieval of testicular spermatozoa has permitted that many men previously considered infertile become parents (Schlegel et al, 1997). Because of the heterogeneity within the testis of NOA patients, surgical sperm retrieval techniques, including conventional testicular sperm extraction (TESE), testicular sperm aspiration (TESA), and microTESE, have all been successfully used
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