title: Predictive factors of repeat sperm aspiration success.
abstract: OBJECTIVE
  To evaluate the outcomes of repeated testicular sperm aspirations (TESAs) and to investigate whether the interval between TESA procedures, success in the first attempt, and patient age might influence the results.
  
  
  METHODS
  The patient population in the present study consisted of couples undergoing TESA for intracytoplasmic sperm injection. Of these, 189, 46, 42, and 19 male patients underwent 1, 2, 3, and 4 sperm retrievals, respectively. The effects of the interval between TESA procedures, success of the previous attempts, and patient age on sperm recuperation in a repeated procedure were evaluated.
  
  
  RESULTS
  Of the patients with nonobstructive azoospermia from whom sperm was not retrieved in the first procedure, 16.6% had successful sperm retrieval at the second procedure. In 57.1% of the patients who did not achieve sperm recuperation for the second attempt, sperm could be retrieved in the third procedure. Finally, of the patients without success in the third attempt, 40.0% had successful sperm retrieval at the fourth attempt. Success in the preceding TESA procedure positively influenced the success of sperm retrieval in a repeated attempt, and a trend for a negative effect of paternal age in the success of a repeated TESA attempt was noted. However, the interval between procedures had no influence on TESA success.
  
  
  CONCLUSIONS
  The results of our study have shown that patient age and the success of the first TESA may predict the results of additional attempts. However, TESA may result in sperm recovery even when the first recovery procedure was not successful. Moreover, sperm recovery did not seem to be affected by the interval between procedures.
authors.affiliation: Fertility-Assisted Fertilization Center, São Paulo, São Paulo, Brazil. edson@fertility.com.br
authors.forename: Edson
authors.initials: E
authors.lastname: Borges
authors.forename: Daniela Paes de Almeida Ferreira
authors.initials: DP
authors.lastname: Braga
authors.forename: Tatiana Carvalho de Sousa
authors.initials: TC
authors.lastname: Bonetti
authors.forename: Fabio Firmback
authors.initials: FF
authors.lastname: Pasqualotto
authors.forename: Assumpto
authors.initials: A
authors.lastname: Iaconelli
mesh_terms: D000367:Age Factors; D006801:Humans; D008297:Male; D053625:Sperm Retrieval / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome