A comparison between open and percutaneous needle biopsies in men with azoospermia

Abstract

Open testicular biopsy is a classic method of investigation in men with azoospermia. Recently, percutaneous needle biopsy of the testis has been used in attempts to obtain material for histopathological diagnosis in such cases and to retrieve spermatozoa for intracytoplasmic sperm injection (ICSI). To determine whether a 19 gauge (G) and a 21G butterfly needle could be used for percutaneous aspiration of testicular tissue to determine the presence of mature spermatids and assess spermatogenesis, 10 patients (16 testes) and 12 patients (17 testes) underwent 19G or 21G needle biopsy respectively, immediately followed by open testicular biopsy, with both procedures under local anaesthesia. Biopsy with each needle size was compared with open biopsy. With the 19G needle, in the 14 cases where material was obtained there was full agreement with open biopsy regarding the presence or absence of mature spermatozoa, whereas with the 21G needle only nine of the 13 biopsies yielding material were predictive in this respect. Each needle size correlated poorly with open biopsy regarding evaluation of spermatogenesis. We conclude that percutaneous biopsy with a 19G butterfly needle is a quick and reliable method for demonstrating spermatozoa for ICSI. But for a detailed histopathological diagnosis, however, the needle biopsies gave poor results, whereas the material from the open testicular biopsies was assessable.

Effect of testicular spermatozoa on embryo quality and pregnancy in patients with non-obstructive azoospermia

“…Importantly, IVF-ICSI using surgically retrieved spermatozoa is the only method available that allows men with non-obstructive azoospermia (NOA) to father their own genetic offspring [Devroey et al 1995;Silber et al 1996]. The spermatozoa recovery rate in TESE has been shown to range from 40-70% [Mansour et al 1996;Friedler et al 1997;Schlegel et al 1997;Rosenlund et al 1998], and acceptable fertilization and pregnancy rates using testicular spermatozoa from men with NOA have been reported De Croo et al 2000;Mercan et al 2000;Balaban et al 2001]. Among the subgroups of NOA, Giorgetti et al [2005] reported that the fertilization rate was significantly lower when the patient exhibited maturation arrest (MA) as opposed to hypospermatogenesis (HS).…”

Microdissection testicular sperm extraction causes spermatogenic alterations in the contralateral testis

“…On the other hand, M-TESE has been increasingly used due to better results in obtaining testicular sperm, when compared to TESE (Devroey et al, 1995;Schlegel and Su, 1997;Schlegel, 1999). Failure to retrieve sperm in non-obstructive azoospermia patients may be as high as 57% of patients (Friedler et al, 1997;Rosenlund et al, 1998;Okada et al, 2002).…”

Testicular sperm aspiration in men with presumed non-obstructive azoospermia: Analysis of FSH level as a predictor of successful sperm retrieval

“…There is only one reported complication requiring surgical correction, which was testicular bleeding managed with hemostatic suturing [2,3,[13][14][15][16][17] . Hematomas can occur and tend to reabsorb within 1-4 weeks [8] .…”