Efficacy of percutaneous needle aspiration and open biopsy for sperm retrieval in men with non-obstructive azoospermia.
OBJECTIVE
To assess the efficacy of the two most common sperm retrieval procedures, testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) as part of the diagnostic work-up in men with non-obstructive azoospermia. Design. Retrospective cohort study.


METHODS
Center for Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.


METHODS
Three hundred fifty men who underwent diagnostic surgical sperm recovery between January 1997 and December 2006.


METHODS
A diagnostic TESA was initially performed in 281 men with testes of >12 mm(3). If no spermatozoa or an insufficient number of spermatozoa was found, most of the men underwent a diagnostic TESE. Diagnostic TESE was performed as the only surgical procedure in 69 men who had at least one testis < or =12 mm(3).


METHODS
Success rates of diagnostic TESA and diagnostic TESE.


RESULTS
Spermatozoa were found in 129 (45.9%) of the 281 men who underwent TESA. However, in 29 of these men too few spermatozoa were identified for the men to be accepted for IVF/ICSI. The subsequent TESE resulted in 26 additional men being accepted for IVF/ICSI. In men with testes < or =12 mm(3) a sufficient number of spermatozoa were found in 27 out of 69 men following TESE.


CONCLUSIONS
The study shows that in 52% of the men with non-obstructive azoospermia spermatozoa useful for ICSI can be identified. For at least one-third of the men with testes >12 mm(3) TESA is a sufficient procedure. Sperm retrieval rate is further increased following a subsequent TESE.
Houwen
Juul
J
Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, the Netherlands.
Lundin
Kersti
K
Söderlund
Brita
B
Bergh
Christina
C
Kremer
Jan A M
JA
Ekerhovd
Erling
E
D000328:Adult; D053713:Azoospermia / Q000175:diagnosis* / Q000473:pathology; D044963:Biopsy, Fine-Needle / Q000379:methods*; D015331:Cohort Studies; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D053625:Sperm Retrieval; D013737:Testis / Q000473:pathology