In a nutshell
This study investigated fertility outcomes after testicular sperm extraction (TESE) for non-obstructive azoospermia (NOA).
They found that there were no differences in fertility outcomes with conventional (cTESE) or micro TESE (mTESE).
Some background
Male infertility (MI) is involved in 50% of infertility cases. The level of MI can vary. Azoospermia is a severe MI condition. Men with azoospermia do not have any sperm in their semen. This can be caused by a blockage in the duct from the testes. Non-obstructive azoospermia (NOA) is not caused by a blockage. It is the most serious cause of MI.
Treatment of NOA involves a procedure to harvest sperm directly from the testes. One type of procedure is called testicular sperm extraction (TESE). Conventional TESE (cTESE) involves taking a biopsy of the testis. The sample is taken from a random area. Micro TESE (mTESE) is a targeted procedure. The surgeon will take a biopsy from an area with high sperm. Intracytoplasmic sperm injection (ICSI) can be then used to fertilize an oocyte (egg). It is unclear if cTESE or mTESE has better fertility outcomes.
Methods & findings
This study reviewed 117 studies comparing cTESE and mTESE. This included 21, 404 male patients. The success of TESE is measured by the amount of sperm retrieved. This is called the sperm retrieval rate (SRR). The SRR was compared between cTESE and mTESE in the studies. 42 studies looked at fertility outcomes. They included pregnancy rate (PR) and live birth rate (LBR).
The average SRR per TESE cycle was 47%. The volume or size of the testis affected the SRR. A testicular volume higher than 12.5 ml was associated with a SRR higher than 60%. SRR was similar for cTESE and mTESE. The overall LBR was 28% after SRR and ICSI. There were no differences in PR or LBR between cTESE and mTESE.
The bottom line
The authors concluded that there were no differences in fertility outcomes with cTESE or mTESE.
The fine print
Some patient data were not available for this analysis. This could influence the findings in this study. More controlled studies are needed.
What’s next?
If you have any concerns regarding infertility please consult with your physician.
Published By :
Human Reproduction Update
Date :
Oct 30, 2019
