Comparing the effectiveness of microdissection testicular sperm extraction versus multiple needle-pass percutaneous testicular sperm aspiration in infertile men with non-obstructive azoospermia.

This study directly compared the effectiveness of microdissection testicular sperm extraction (mTESE) versus multiple needle-pass percutaneous testicular sperm aspiration (TESA) in infertile men with non-obstructive azoospermia (NOA). The data showed that the sperm retrieval rate was higher with mTESE than with multiple needle-pass TESA in these patients.

Around 10% of infertile men suffer from non-obstructive azoospermia (NOA). This describes a condition in which very few sperm cells are produced in the testicles (not enough to reach the ejaculated semen). In these cases, sperm should be collected (retrieved) directly from the testicles. The only way to obtain sperm cells for in-vitro fertilization (IVF; the artificial matching of eggs and sperm cells in a laboratory dish) in these men is via surgical procedures.

Microdissection testicular sperm extraction (mTESE) involves the retrieval of sperm by surgically sampling small bits of testicular tissue using a microscope. Multiple needle-pass percutaneous testicular sperm aspiration (TESA) involves the retrieval of testicular tissue using multiple needle passes. It is not known how these two procedures compare to each other in the effectiveness of collecting sperm in infertile men with NOA.

This study involved 100 infertile men with NOA. Patients were randomly divided into 2 groups. 49 patients underwent mTESE and 51 patients underwent TESA procedures. Patients with failed TESA received salvage mTESA.

Sperm cells were retrieved in 43% of men treated with mTESE versus 22% of men treated with TESA. The sperm retrieval rate was 29% in men treated with multiple needle-pass TESA plus salvage mTESE.

6% of the men treated with mTESE experienced a complication versus 0% in men treated with multiple needle-pass TESA.

No significant differences in reproductive hormones were observed between the groups after 6 months.

This study concluded that the sperm retrieval rate was higher with mTESE than with multiple needle-pass TESA in infertile men with NOA.

The sample size was very small. This study only included patients from Denmark and Sweden. More studies are required to validate the conclusions.