title: [Three-step sperm retrieval for 73 non-obstructive azoospermia patients].
abstract: OBJECTIVE
  To investigate the value and clinical application of the Three-Step Sperm Retrieval method in improving the sperm retrieval rate for non-obstructive azoospermia (NOA) patients.
  
  
  METHODS
  Seventy-three NOA patients underwent Three-Step Sperm Retrieval in the following order of procedures: testicular fine needle aspiration (TFNA), testicular sperm extraction (TSE), and microdissection testicular sperm extraction (MD-TSE). The testicular tissue obtained from each step was observed for spermatozoa under the 400-fold inverted microscope. If spermatozoa were found in one step, the operation would be stopped; otherwise, the next step would be carried out. The testicular tissue was subjected to pathological examination.
  
  
  RESULTS
  Spermatozoa was found in the testicular tissue in 38.4% of the cases (28/73) at TFNA as the first step, in 52.1% (38/73) at TFNA and TSE, and in 64.4% (47/73) at TFNA, TSE and MD-TSE. Pathological examination showed 25 of the cases to be Sertoli cell-only syndrome, 21 to be sperm maturation arrest and the other 27 to be hypospermatogenesis, in which spermatozoa were found in 10, 14 and 23 cases, respectively.
  
  
  CONCLUSIONS
  The Three-Step Sperm Retrieval method can significantly improve the sperm retrieval rate for NOA patients. And the sperm retrieval rate is associated with the pathological type of the testicular tissue, a higher rate with hypospermatogenesis.
authors.affiliation: Shanghai Human Sperm Bank, Department of Urology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Ma
authors.forename: Ping
authors.initials: P
authors.lastname: Ping
authors.forename: Jian-Hu
authors.initials: JH
authors.lastname: Wang
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.forename: Shi
authors.initials: S
authors.lastname: Yang
authors.forename: Jian-Shan
authors.initials: JS
authors.lastname: Zhu
authors.forename: Hui
authors.initials: H
authors.lastname: Lu
authors.forename: Hong-Liang
authors.initials: HL
authors.lastname: Hu
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D053713:Azoospermia; D006801:Humans; D008297:Male; D053625:Sperm Retrieval; D013737:Testis / Q000473:pathology / Q000601:surgery*