Serial ultrasonography, hormonal profile and antisperm antibody response after testicular sperm aspiration.
BACKGROUND
In many fertility centres, intracytoplasmic sperm injection (ICSI) with epididymal or testicular spermatozoa is a routine treatment for men with azoospermia. In this prospective study, the physiological consequences after testicular sperm aspiration (TESA), using suction and a 19 gauge needle, were evaluated.


RESULTS
Thirty-five consecutive men with azoospermia underwent TESA. Testicular ultrasonography with Doppler flow imaging was performed and testicular volumes were evaluated pre-operatively and 3 months after aspiration. If focal testicular lesions were found, further examinations were performed 6 and 9 months after TESA. Serum FSH, testosterone and antisperm antibodies (ASA) were analysed. Focal testicular lesions were seen in four out of 61 testes (6.6%) at the 3 month investigation point. Three lesions were resolved after 6 months and all after 9 months. Testicular echogenicity remained unchanged in 50 cases (82%) 3 months after TESA. Four men (11.4%) reported severe subjective discomfort post-operatively, but only one had a medical consultation where an intratesticular haematoma was diagnosed. There were no significant changes in FSH and testosterone after surgery and testicular volumes were similar after 3 months. There were three borderline cases of ASA in serum, but none was classified as ASA-positive.


CONCLUSIONS
The puncture method of testicular sperm aspiration seems to be a safe method for sperm retrieval, with minimal physiological consequences.
Westlander
G
G
Centre for Reproductive Medicine, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden. goran.westlander@medfak.gu.se
Ekerhovd
E
E
Granberg
S
S
Lycke
N
N
Nilsson
L
L
Werner
C
C
Bergh
C
C
D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy*; D011446:Prospective Studies; D011677:Punctures; D013094:Spermatozoa / Q000276:immunology*; D013737:Testis / Q000166:cytology / Q000000981:diagnostic imaging*; D013739:Testosterone / Q000097:blood; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014463:Ultrasonography
D001323:Autoantibodies; D013739:Testosterone; D005640:Follicle Stimulating Hormone