title: [Sperm retrieval and the predictive parameter of non-obstructive azoospermia: a meta-analysis of literatures 1990 to 2008].
abstract: OBJECTIVE
  To investigate which sperm retrieval technique is suitable for the non-obstructive azoospermia (NOA) patient, and to identify the relevant predictive parameters.
  
  
  METHODS
  Literatures on NOA patients who had undergone sperm retrieval and pathological examination of testis were identified from Cochrane Library, CNKI and Medline (1990 to 2008) and analyzed.
  
  
  RESULTS
  Twenty-five articles were enrolled. When testicular fine needle aspiration (TEFNA) was compared with testicular sperm extraction (TESE), the sperm retrieval rate of the former was 23.0%, significantly lower than that of the latter (52.2%, RR: 0.49, 95%CI: 0.41 - 0.60, P < 0.05); and when TESE was compared with micro-surgical testicular sperm extraction (mTESE), the sperm retrieval rate of the former was 35.7%, significantly lower than that of the latter (54.6%, RR: 0.70, 95%CI: 0.50 - 0.98, P < 0.05). Sperm retrieval rate was closely correlated with the testicular pathological category of the NOA patients. The sperm retrieval rates of the patients with hypospermatogenesis (HS), maturation arrest (MA), and Sertoli cell only syndrome (SCOS) were 76.7%, 46.2%, and 32.8% respectively (RR: 1.65, 2.40, 1.50; 95%CI: 1.21 - 2.91, 1.85 - 6.90, 1.02 - 2.26, P < 0.05).
  
  
  CONCLUSIONS
  mTESE is the best sperm retrieval technique. A better to choice before deciding the treatment program of NOA patients is to identify the testicular pathological category in the NOA patients, and then to predict the outcome of TESE before assisted reproduction technology.
authors.affiliation: Department of Urology, First Affiliated Hospital of Gannan Medical College, Ganzhou 341000, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Liu
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Zou
authors.forename: Yuan-Hu
authors.initials: YH
authors.lastname: Yuan
authors.forename: Ri-Hai
authors.initials: RH
authors.lastname: Xiao
authors.forename: Geng-Qing
authors.initials: GQ
authors.lastname: Wu
authors.forename: Xiao-Ning
authors.initials: XN
authors.lastname: Wang
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Wu
authors.forename: Da-Zhi
authors.initials: DZ
authors.lastname: Long
authors.forename: Fo-Lin
authors.initials: FL
authors.lastname: Liu
authors.forename: Min
authors.initials: M
authors.lastname: Liu
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
mesh_terms: D053713:Azoospermia / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D053625:Sperm Retrieval; D013737:Testis / Q000473:pathology