Microdissection TESE (MD-TESE) Does not Improve Sperm Retrieval Rate but Contributes to Favorable Pregnancy Rate in Non-Obstructive Azoospermic (NOA) Patients

Hatsuki Hibi; Tadashi Ohori; Yoshiaki Yamada; Nobuaki Honda; Chikako Ito; Miho Sano; Yoshiki Hashiba; Yoshimasa Asada

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Microdissection TESE (MD-TESE) Does not Improve Sperm Retrieval Rate but Contributes to Favorable Pregnancy Rate in Non-Obstructive Azoospermic (NOA) Patients

Author(s):

Hatsuki Hibi^1,*,

Tadashi Ohori²,

Yoshiaki Yamada³,

Nobuaki Honda³,

Chikako Ito²,

Miho Sano²,

Yoshiki Hashiba²,

Yoshimasa Asada²

1Department of Urology, Kyoritsu General Hospital, hibih@quartz.ocn.ne.jp, Japan

2Department of Urology, Kyoritsu General Hospital, Japan

3Department of Urology, Aichi Medical University School of Medicine, Japan

Nephro-Urology Monthly:Vol. 2, issue 3; 455-461

Article type:Research Article

Received:Oct 19, 2009

Accepted:Nov 07, 2009

How to Cite:Hatsuki HibiTadashi OhoriYoshiaki YamadaNobuaki HondaChikako ItoMiho SanoYoshiki HashibaYoshimasa Asadaet al.Microdissection TESE (MD-TESE) Does not Improve Sperm Retrieval Rate but Contributes to Favorable Pregnancy Rate in Non-Obstructive Azoospermic (NOA) Patients.Nephro-Urol Mon.2(3):455-461.

Abstract

Background and Aims:

Microdissection testicular sperm extraction TESE (MD-TESE), which can improvesurgical sperm retrieval rate is widely applied in sperm retrieval surgery in non-obstructive azoospermic (NOA) patients. We assessed whether MD-TESE can improve sperm retrieval rate as well as Intracytoplasmic sperm injection (ICSI) results.

Methods:

A retrospective comparative study involving 86 NOA patients who underwent 6-8 conventional multiple TESE (C-TESE) procedures was conducted. Another 116 NOA patients underwent MD-TESE. CTESE and MD-TESE were employed for the bilateral testis via a median raphe incision under spinal or local anesthesia with spermatic block.

Results:

Motile sperm recovery was achieved in 26 (30.2%) and 30 (25.8%) patients with C-TESE and MDTESE,respectively. Collected sperm was cryopreserved. All couples in which motile sperm was recovered received ICSI utilizing frozen-thawed sperm samples. Overall pregnancy rates of the C-TESE and MD-TESE groups were 23% (6/26) and 40% (12/30), respectively. Abortion was not observed in either group and healthy deliveries resulted. Statistical differences in sperm recovery and pregnancy rate were not evident between the groups (P=0.495, P=0.182, respectively). Moreover, no successful pre-operative predictors of sperm recovery were identified.

Conclusions:

These data demonstrated that MD-TESE does not improve sperm recovery rate; however, MD-TESE contributes to favorable pregnancy rate in NOA patients.

Keywords

Non-Obstructive Azoospermia

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