title: Conventional testicular sperm extraction (TESE) and non-obstructive azoospermia: is there still a chance in the era of microdissection TESE? Results from a single non-academic community hospital.
abstract: Spermatozoa can be retrieved in non-obstructive azoospermia (NOA) patients despite the absence of ejaculated spermatozoa in their semen because of the presence of isolated foci with active spermatogenesis. Conventional testicular sperm extraction (c-TESE) in patients with NOA has been partially replaced by micro-TESE. It is still under debate the problem regarding the higher costs related to micro-TESE when compared with c-TESE. In this study, we evaluated sperm retrieval rate (SRR) of c-TESE in naive NOA patients. Sixty-three NOA patients were referred to our centre for a c-TESE. For every subject, we collected demographic data, cause of infertility, time to first infertility diagnosis, serum levels of LH, FSH, total testosterone and prolactin. A statistical analysis was conducted to correlate all the clinical variables, the histology and the Johnsen score with the SRR. Sixty-three consecutive NOA patients with a mean age of 37.3 years were included. The positive SRR was 47.6%. No statistical differences were observed between positive vs. negative SRR regarding mean FSH (17.12 vs. 19.03 mUI/mL; p = 0.72), and LH (9.72 vs. 6.92 mUI/mL; p = 0.39) values. Interestingly, we found a statistically significant difference in terms of time to first infertility diagnosis (+SRR vs. -SRR; 44.5 vs. 57 months; p = 0.02) and regarding to age (+SSR vs. -SRR; 40.1 vs. 35.3; p = 0.04). There was a statistically significant decrease in SRRs with the decline in testicular histopathology from hypospermatogenesis to maturation arrest, and SCO. The mean Johnsen score was 5.9 with a mean percentage of Johnsen score ≥8 tubules equal to 19%. The overall pregnancy rate was 26.6%. In our prospective cohort of patients successful SRR with c-TESE was 47.6%. Lower costs and high reproducibility of this technique still support this procedure as an actual reliable option in NOA patients for sperm retrieval.
authors.affiliation: Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Saccà
authors.affiliation: Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy.
authors.forename: A L
authors.initials: AL
authors.lastname: Pastore
authors.affiliation: Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Roscigno
authors.affiliation: Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Naspro
authors.affiliation: Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pellucchi
authors.affiliation: Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Fuschi
authors.affiliation: Department of Urology, IRCSS Policlinico San Donato, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Maruccia
authors.affiliation: Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Territo
authors.affiliation: Department of Urology, AO Città della Salute e della Scienza, University of Torino, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pisano
authors.affiliation: Department of Maternal and Pediatric, USSD Centro PMA, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Zanga
authors.affiliation: Department of Maternal and Pediatric, USSD Centro PMA, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Capitanio
authors.affiliation: Urology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Latina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Carbone
authors.affiliation: Department of Maternal and Pediatric, USSD Centro PMA, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fusi
authors.affiliation: Department of Pathology, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Chinaglia
authors.affiliation: Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: L F
authors.initials: LF
authors.lastname: Da Pozzo
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000097:blood / Q000473:pathology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006764:Hospitals, Community; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012189:Retrospective Studies; D053625:Sperm Retrieval; D013094:Spermatozoa / Q000473:pathology*; D013737:Testis / Q000473:pathology*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: infertility; non-obstructive azoospermia; spermatozoa retrieval; testicular sperm extraction