Testicular microdissection following failed sperm aspiration: a single-center experience

K. Alrabeeah, B. Hakami, S. Abumelha, Y.A. Noureldin, M. Alzughaibi, A. Alhaider, R. Almannie, B.H. Alsaikhan, A. Alkhayal

College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia. basel_1408@hotmail.com

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• Reproductive Medicine
• Urology

OBJECTIVE: Azoospermia is a cause of infertility in a subgroup of infertile men. Sperm retrieval techniques including testicular sperm aspiration (TESA) and microscopic testicular sperm extraction (mTESE) are widely used. In this study, we have reviewed our findings regarding mTESE performed following a negative TESA outcome.

PATIENTS AND METHODS: This is a retrospective chart review study that included 41 infertile patients who underwent mTESE after a negative TESA outcome. Charts were reviewed for demographic data, type of infertility, and type of azoospermia. Hormone level analysis was done for follicle-stimulating hormone, luteinizing hormone, and testosterone. Testicular volume was estimated by ultrasound.

RESULTS: The study included 41 patients who underwent mTESE following a negative TESA outcome. Most patients had primary infertility (n = 32; 78%). Of the 41 patients, four had a previous history of either TESE or orchidopexy, and two had a history of varicocelectomy before the recent percutaneous TESA procedure. There was no significant association between sperm retrieval and the different surgical procedures that had been performed. Of the 41 patients, 27 had positive sperm retrieval by mTESE with a success rate of 65.9%.

CONCLUSIONS: The positive sperm retrieval rate of mTESE performed following a negative TESA outcome was reasonable (65.9%). No significant correlations were identified with all variables studied.

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