Controlled comparison of percutaneous and microsurgical sperm retrieval in men with obstructive azoospermia

A controlled comparison of the efficacy and reliability of sperm retrieval by testicular fine needle aspiration (TFNA), percutaneous testicular needle biopsy (PercBiopsy) and microsurgical epididymal sperm aspiration (MESA) was performed in nine patients with obstructive azoospermia. During a planne...

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Bibliographic Details
Published in:Human reproduction (Oxford) 1998-11, Vol.13 (11), p.3086-3089
Main Authors: Sheynkin, Y R, Ye, Z, Menendez, S, Liotta, D, Veeck, L L, Schlegel, P
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biopsy, Needle - instrumentation
Biopsy, Needle - methods
Gynecology. Andrology. Obstetrics
Humans
Male
Male genital diseases
Medical sciences
Microsurgery
Middle Aged
Non tumoral diseases
Oligospermia - pathology
Sperm Count
Sperm Motility
Spermatozoa
Suction
Testis - pathology
Testis - surgery
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Summary:A controlled comparison of the efficacy and reliability of sperm retrieval by testicular fine needle aspiration (TFNA), percutaneous testicular needle biopsy (PercBiopsy) and microsurgical epididymal sperm aspiration (MESA) was performed in nine patients with obstructive azoospermia. During a planned MESA procedure, sperm retrieval was attempted on the same testis with TFNA and PercBiopsy. Spermatozoa were obtained from all patients using MESA and PercBiopsy. Spermatozoa were retrieved using TFNA from 6/9 (67%) men. The mean number of epididymal spermatozoa retrieved with MESA (15 x 106) was significantly higher (P = 0.003) than that retrieved percutaneously from the testis. The mean number of spermatozoa obtained by PercBiopsy was 0.116 x 10(6) while TFNA recovered 0.014 x 106 spermatozoa (P = 0.025). MESA is the optimal choice to retrieve the greatest number of spermatozoa with highest motility for assisted reproduction and subsequent cryopreservation. However, percutaneous testicular retrieval does not require microsurgical expertise and is less invasive. Our results suggest that the optimal percutaneous procedure for sperm retrieval from the testis involves percutaneous testicular needle biopsy with an automatic biopsy gun.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/13.11.3086