title: Technical modification of testicular sperm extraction expedites testicular sperm retrieval.
abstract: OBJECTIVE
  To determine the predictive value and the quality of supernatant sperm (SS) achieved by a simple laboratory technical modification after testicular sperm extraction (TESE).
  
  
  METHODS
  A retrospective analysis.
  
  
  METHODS
  An IVF unit in a university medical center.
  
  
  METHODS
  Azoospermic patients undergoing TESE between January 2001 and December 2006.
  
  
  METHODS
  Before the mechanical shredding, the testicular specimen in toto was placed in medium. The medium was spun and the pellet resuspended and transferred for SS detection. Then a wet preparation of the testicular tissue was shredded roughly and inspected for tissue sperm (TS) as described.
  
  
  METHODS
  Detection of SS versus TS, fertilization and pregnancy rates (PR) after intracytoplasmic sperm injection (ICSI) with SS versus TS.
  
  
  RESULTS
  The SS was detected in all specimens where TS was eventually found, independent of their testicular pathology. When the supernatant was spermatozoa-negative, no spermatozoa were detected in the tissue. For embryos derived from ICSI the fertilization rate of SS was significantly higher than TS (52% vs. 44%), whereas the PR was comparable.
  
  
  CONCLUSIONS
  The SS serves as an excellent predictor of TESE outcome and as a superior source for fertilization. This modified technique enables faster decision of TESE outcome and an easier switch to donor sperm when available.
authors.affiliation: In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Hadassah Hebrew University Hospital, Mt. Scopus, Jerusalem, Israel. kochman@hadassah.org.il
authors.forename: Ronit
authors.initials: R
authors.lastname: Haimov-Kochman
authors.forename: Tal
authors.initials: T
authors.lastname: Imbar
authors.forename: Francine
authors.initials: F
authors.lastname: Lossos
authors.forename: Iris
authors.initials: I
authors.lastname: Nefesh
authors.forename: Bat-Sheva
authors.initials: BS
authors.lastname: Zentner
authors.forename: Yulia
authors.initials: Y
authors.lastname: Moz
authors.forename: Diana
authors.initials: D
authors.lastname: Prus
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bdolah
authors.forename: Arye
authors.initials: A
authors.lastname: Hurwitz
mesh_terms: D053713:Azoospermia / Q000175:diagnosis; D005260:Female; D005306:Fertilization / Q000502:physiology*; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods; D053625:Sperm Retrieval / Q000706:statistics & numerical data*; D013094:Spermatozoa; D013737:Testis