title: Live birth rate with repeat microdissection TESE and intracytoplasmic sperm injection after a conventional testicular biopsy in men with nonobstructive azoospermia.
abstract: OBJECTIVE
  To determine live birth rate via m-TESE and ICSI in men who had a previous conventional testicular biopsy.
  
  
  METHODS
  Retrospective study was conducted to analyze 86 m-TESE procedures for ICSI in NOA patients who had a previous conventional TESE. Only motile spermatozoa were used for ICSI and all other forms were discarded. Women under the age of 42 years and who produced at least 3 oocytes in response to controlled ovarian stimulation were included in the study. Statistical significance was tested using Student's t-test, χ(2) test and Fisher's exact test as appropriate.
  
  
  RESULTS
  Testicular motile spermatozoa were successfully retrieved in 39 out of 47 men who had spermatozoa found in the previous biopsy (Group I), and in 6 out of 39 men with no sperm in the previous biopsy (Group II) (82.9% vs. 15.3%, respectively; p<0.01). Demographic characteristics of two groups were similar. Live birth rate per repeat m-TESE attempt via ICSI was significantly higher (23.4%, 39/47) in patients with a previous sperm-positive TESE compared to that (2.5%, 1/39) obtained in patients with a previous sperm-negative testicular biopsy (p<0.05).
  
  
  CONCLUSIONS
  Repeat attempt to obtain motile spermatozoa by m-TESE following conventional TESE ensures a higher recovery and live birth rate in men who had spermatozoa found in the first recovery procedure compared to men with no spermatozoa in the first testicular biopsy. Live birth rate through ICSI is not promising after repeat m-TESE procedure in patients with a previous sperm-negative testicular biopsy.
authors.affiliation: Ota-Jinemed Hospital Obstetrics and Gynecology Department IVF Unit, Nuzhetiye cad., Istanbul, Turkey. Electronic address: karacanmeric1@gmail.com.
authors.forename: Meric
authors.initials: M
authors.lastname: Karacan
authors.affiliation: Ota-Jinemed Hospital Obstetrics and Gynecology Department IVF Unit, Nuzhetiye cad., Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ulug
authors.affiliation: Ota-Jinemed Hospital Obstetrics and Gynecology Department IVF Unit, Nuzhetiye cad., Istanbul, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Arvas
authors.affiliation: Ota-Jinemed Hospital Obstetrics and Gynecology Department IVF Unit, Nuzhetiye cad., Istanbul, Turkey.
authors.forename: Ziya
authors.initials: Z
authors.lastname: Cebi
authors.affiliation: Ota-Jinemed Hospital Obstetrics and Gynecology Department IVF Unit, Nuzhetiye cad., Istanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Erkan
authors.affiliation: Ota-Jinemed Hospital Obstetrics and Gynecology Department IVF Unit, Nuzhetiye cad., Istanbul, Turkey.
authors.forename: Teksen
authors.initials: T
authors.lastname: Camlıbel
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000473:pathology / Q000628:therapy*; D001706:Biopsy; D001723:Birth Rate; D005260:Female; D006801:Humans; D008297:Male; D042282:Microdissection; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000473:pathology; D013737:Testis / Q000473:pathology*; D016896:Treatment Outcome
keywords: Azoospermia; Intracytoplasmic sperm injection; Microdissection testicular sperm extraction (m-TESE); Testicular spermatozoa