title: Vascularity index distribution within the testis: a technique for guiding testicular sperm extraction.
abstract: Azoospermia is defined as the absence of spermatozoa in the ejaculate, although some foci of spermatogenesis may exist in the testes of these men. Currently, there are no clinical, seminal or hormonal parameters for identifying spermatogenesis within the testis sufficient for achieving genetic offspring. As a result, multiple biopsies are performed at several arbitrary sites of both testes in search of spermatozoa. We developed a power Doppler (PD) ultrasound (US) image-based technique that predicts sites with the greatest potential for spermatogenesis. PDUS images of the testes of azoospermic men were acquired at seven cross-sections to reconstruct a 3-D matrix for constructing a spatial map of preferential regions where spermatozoa are most likely to exist. This technique may obviate the need for arbitrary multiple biopsies that inflict some degree of damage upon testicular tissue, and may increase the success rate of identifying viable spermatozoa in testicular biopsies.
authors.affiliation: Ultrasound Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. osnate@post.tau.ac.il
authors.forename: O
authors.initials: O
authors.lastname: Eytan
authors.forename: J
authors.initials: J
authors.lastname: Har-Toov
authors.forename: G
authors.initials: G
authors.lastname: Fait
authors.forename: H
authors.initials: H
authors.lastname: Yavetz
authors.forename: R
authors.initials: R
authors.lastname: Hauser
authors.forename: L
authors.initials: L
authors.lastname: Yogev
authors.forename: A
authors.initials: A
authors.lastname: Botchan
authors.forename: D
authors.initials: D
authors.lastname: Ben-Yosef
authors.forename: D
authors.initials: D
authors.lastname: Elad
authors.forename: A J
authors.initials: AJ
authors.lastname: Jaffa
mesh_terms: D001706:Biopsy; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D008297:Male; D009845:Oligospermia / Q000473:pathology* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013091:Spermatogenesis / Q000502:physiology*; D013094:Spermatozoa / Q000502:physiology*; D013737:Testis / Q000098:blood supply* / Q000473:pathology* / Q000503:physiopathology; D020858:Tissue and Organ Harvesting; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation*