Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Internal Medicine Neurology Oncology Pediatrics Respiratory Medicine Surgery
Congress Coverage
2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting

Keynote Webinar | Spotlight on Diet and Diabetes

Watch on-demand

An expert-led symposium exploring the prevention and management of type 2 diabetes through dietary interventions. 
ADVANCED SEARCH
Log in
Top
International Urology and Nephrology
Published in: International Urology and Nephrology 9/2023

18-06-2023 | Infertility | Urology - Original Paper

Comparison of unilateral and bilateral microdissection testicular sperm extraction (MD-TESE) in patients with non-obstructive azoospermia: a prospective study

Authors: Adem Utlu, Fatih Ozkaya, Tugay Aksakalli, Ahmet Emre Cinislioglu, Saban Oguz Demirdogen, Mehmet Sefa Altay, Ibrahim Karabulut, Isa Ozbey, Sibel Guclu Utlu

Published in: International Urology and Nephrology | Issue 9/2023

Login to get access

Abstract

Objective

To compare sperm retrieval rates between unilateral and bilateral microdissection testicular sperm extraction (MD-TESE) procedures in patients with non-obstructive azoospermia and to contribute to the literature by comparing them with literature data.

Methods

This prospective study included 84 males with primary infertility who had azoospermic NOA, who had been married for at least one year, and whose female partners did not have a history of infertility. The study was conducted between January 2019 and January 2020. MD-TESE was applied bilaterally to 48% (n:41) (Group 1) and unilaterally to 52% (n:43) (Group 2) of the patients, and sperm retrieval rates were compared.

Results

There was no statistically significant difference between Group 1 patients and Group 2 patients in terms of sperm availability (61%, 56.5%, p=0.495, respectively). In addition, while no complications were observed in unilateral MD-TESEs, 3 complications were observed in bilateral MD-TESEs.

Conclusions

In our study, it was determined that there was no significant difference between the groups in terms of sperm availability in patients with NOA. Considering the operative time and complication rates of bilateral MD-TESE in patients diagnosed with NOA and the possible MD-TESE procedures that may be performed later, we believe that unilateral MD TESE is a more preferable procedure for the patient and surgeon in this patient group.
Literature
1.
Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AM (2000) WHO manual for the standardized investigation and diagnosis of the infertile male. Cambridge University Press, Cambridge
2.
Göktolga Ü, Izetbegovic S, Rama A, Spahovic H, Göktaş C (2015) The first report from bosnia and herzegovina on micro-tese results in azoospermic patients. Med Arch 69(3):196 CrossRefPubMedPubMedCentral
3.
Bernie AM, Ramasamy R, Schlegel PN (2013) Predictive factors of successful microdissection testicular sperm extraction. Basic Clin Androl 23(1):1–7 CrossRef
4.
Raman JD, Schlegel PN (2003) Testicular sperm extraction with intracytoplasmic sperm injection is successful for the treatment of nonobstructive azoospermia associated with cryptorchidism. J Urol 170(4):1287–1290 CrossRefPubMed
5.
Jarow JP, Espeland MA, Lipshultz LI (1989) Evaluation of the azoospermic patient. J Urol 142(1):62–65 CrossRefPubMed
6.
Çayan S. Erkek infertilitesi değerlendirme, medikal ve cerrahi tedaviler
7.
Ichioka K, Matsui Y, Terada N, Negoro H, Goto T, Ogawa O (2020) Three-dimensional simulation analysis of microdissection testicular sperm extraction for patients with non-obstructive azoospermia. Andrology 8(5):1214–1221 CrossRefPubMedPubMedCentral
8.
Levin HS (1979) Testicular biopsy in the study of male infertility: its current usefulness, histologic techniques, and prospects for the future. Hum Pathol 10(5):569–584 CrossRefPubMed
9.
Witt MA, Elsner C, Kort HI, Massey JB, Mitchell-Leef D, Toledo AA et al (1995) A live birth from intracytoplasmic injection of a spermatozoon retrieved from testicular parenchyma. J Urol 154(3):1136–1137 CrossRefPubMed
10.
Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S et al (1997) Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod (Oxford, England) 12(1):80–86 CrossRef
11.
Turunc T, Gul U, Haydardedeoglu B, Bal N, Kuzgunbay B, Peskircioglu L et al (2010) Conventional testicular sperm extraction combined with the microdissection technique in nonobstructive azoospermic patients: a prospective comparative study. Fertil Steril 94(6):2157–2160 CrossRefPubMed
12.
Tsujimura A, Matsumiya K, Miyagawa Y, Tohda A, Miura H, Nishimura K et al (2002) Conventional multiple or microdissection testicular sperm extraction: a comparative study. Hum Reprod 17(11):2924–2929 CrossRefPubMed
13.
Schlegel PN (1999) Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod 14(1):131–135 CrossRefPubMed
14.
Schlegel PN (ed) (2009) Nonobstructive azoospermia: a revolutionary surgical approach and results. Seminars in reproductive medicine. Springer, New York
15.
Seo JT, Ko WJ (2001) Predictive factors of successful testicular sperm recovery in non-obstructive azoospermia patients. Int J Androl 24(5):306–310 CrossRefPubMed
16.
Plas E, Riedl CR, Engelhardt PF, Mühlbauer H, Pflüger H (1999) Unilateral or bilateral testicular biopsy in the era of intracytoplasmic sperm injection. J Urol 162(6):2010–2013 CrossRefPubMed
17.
Schulze W, Thoms F, Knuth U (1999) Testicular sperm extraction: comprehensive analysis with simultaneously performed histology in 1418 biopsies from 766 subfertile men. Hum Reprod 14(suppl_1):82–96 CrossRefPubMed
18.
Moein MR, Moein MR, Ghasemzadeh J, Pourmasoumi S (2015) Evaluation of sperm retrieval rate with bilateral testicular sperm extraction in infertile patients with azoospermia. Iran J Reprod Med 13(11):711 PubMedPubMedCentral
19.
Ramasamy R, Reifsnyder JE, Husseini J, Eid P-A, Bryson C, Schlegel PN (2013) Localization of sperm during microdissection testicular sperm extraction in men with nonobstructive azoospermia. J Urol 189(2):643–646 CrossRefPubMed
20.
Franco G, Zavaglia D, Cavaliere A, Leonardo C, Petrucci F, De Cillis A et al (2009) 112 a new stepwise microtese approach in nonobstructive azoospermia. Eur Urol Suppl 4(8):148 CrossRef
21.
Ramasamy R, Yagan N, Schlegel PN (2005) Structural and functional changes to the testis after conventional versus microdissection testicular sperm extraction. Urology 65(6):1190–1194 CrossRefPubMed
22.
Comhaire F (2000) Andropause: hormone replacement therapy in the ageing male. Eur Urol 38(6):655–662 CrossRefPubMed
Metadata
Title
Comparison of unilateral and bilateral microdissection testicular sperm extraction (MD-TESE) in patients with non-obstructive azoospermia: a prospective study
Authors
Adem Utlu
Fatih Ozkaya
Tugay Aksakalli
Ahmet Emre Cinislioglu
Saban Oguz Demirdogen
Mehmet Sefa Altay
Ibrahim Karabulut
Isa Ozbey
Sibel Guclu Utlu
Publication date
18-06-2023
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 9/2023
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-023-03668-0

Other articles of this Issue 9/2023

International Urology and Nephrology 9/2023 Go to the issue

Urology - Letter to the Editor

Thiazide prescriptions are not associated with lower urolithiasis: a Japanese epidemiologic study

Urology - Original Paper

Association between oxidative balance score and urinary incontinence in females: results from the national health and nutrition examination survey in 2005–2018

Urology - Original Paper

Regional and national burden of prostate cancer: incidence, mortality, years of life lost, and disability-adjusted life years, in Mexico and Latin America from 1990 to 2019

Nephrology - Original Paper

Clinicopathological characteristics and associated factors of idiopathic membranous nephropathy with hyperuricemia: a single-centered cross-sectional study

Nephrology - Original Paper

Quality of life, anxiety and depression symptoms in living related kidney donors: a cross‑sectional study

Nephrology - Original Paper

Comparison of the risks of renal cell carcinoma or urothelial cancer between hemodialysis and peritoneal dialysis patients
Webinar | 08-11-2023 | 18:00 (CET)

Keynote Webinar | Spotlight on Diet and Diabetes

Watch now

An expert-led symposium exploring the prevention and management of type 2 diabetes through dietary interventions. Highlights include discussion of the recent EASD guidelines, therapeutic diets, food types and processing, plus psychological factors that influence patient success, and the drivers of healthy eating and diabetes control.
Prof. Mike Lean
Prof. Falko Sniehotta
Image Credits