Advances in sperm retrieval techniques in azoospermic men: A systematic review

Shah, Rupin; Gupta, Chirag

doi:10.1016/j.aju.2017.11.010

Cited by 17 publications

(15 citation statements)

References 28 publications

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“…However, the authors believe that this cost could actually be higher in non-treated varicocele patients because of the failure rate of sperm retrieval before varicocele repair and the need for repeated retrieval. Moreover, repeated surgery leads to a lower success rate since the first attempt is the best chance of sperm retrieval [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Generally, azoospermia is classified as obstructive azoospermia (OA) or non-obstructive azoospermia (NOA). While OA is obviously caused by obstruction, NOA has many possible causes and is more difficult to manage [ 3 ]. In most NOA cases, the treatment of choice is surgery, in which the spermatozoa needed are obtained in the operating room in order to undergo assisted reproductive technology (ART) procedures, such as in vitro fertilization with embryo transfer (IVF-ET), intracytoplasmic sperm injection (ICSI), or intrauterine insemination (IUI).…”

Section: Introductionmentioning

confidence: 99%

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The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis

Birowo

Tendi

Widyahening

et al. 2020

Heliyon

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Introduction: Varicocele is one of the most common treatable causes of male infertility. However, the decision to perform varicocelectomy before starting a fertility program remains controversial. This study aimed to thoroughly review and analyze the benefit of varicocele repair and its impact on the success rate of a fertility program. Materials and methods: A systematic literature search was performed using MEDLINE, Cochrane Library, and Wiley Library. The primary outcome was the pregnancy rate, and the secondary outcomes were live birth rate and surgical sperm retrieval success rate. Outcomes were compared between men who underwent treatment for a varicocele and those that did not. The pooled analysis data are presented as odds ratios with 95% confidence intervals. Results: A total of 31 articles were included in the meta-analysis. The pregnancy rate was significantly higher in the treated group (odds ratio ¼ 1.82; 95% confidence interval: 1.37-2.41; P < 0.0001) along with the live birth rate (odds ratio ¼ 2.80; 95% confidence interval: 1.67-4.72; P ¼ 0.0001). The further subgroup analysis revealed a higher pregnancy rate in treated men with azoospermia, subnormal semen parameters, and normozoospermia (P ¼ 0.04, P ¼ 0.0005, and P ¼ 0.002, respectively), while the live birth rate was only significantly higher in the treated men with subnormal semen parameters and normozoospermia (P ¼ 0.001 and P < 0.0001). Treated varicocele also led to a higher sperm retrieval rate in azoospermic patients (odds ratio ¼ 1.69; 95% confidence interval: 1.16-2.45; P ¼ 0.006). Conclusions: Varicocele repair increased the pregnancy and live birth rates regardless the semen analysis result, along with the sperm retrieval success rate in azoospermic men. Thus, varicocele repair may be beneficial prior to joining a fertility program.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis

Birowo

Tendi

Widyahening

et al. 2020

Heliyon

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“…It is of particular interest that the ubiquitin protein encoded by the USP9Y gene plays an important role in infertility and can affect the polymorphism of the USP9Y gene in male infertilities (34,35). Studies have shown that the levels of sex hormones, such as LH, FSH, and testosterone were significantly higher in infertile men in comparison with healthy men.…”

Section: Discussionmentioning

confidence: 99%

The Assessment of 5 Polymorphisms in the USP9Y Gene in Infertile Patients with Non-obstructive Azoospermia

Kalhor

Fazaeli

Sheikholeslami

et al. 2021

Jentashapir J Cell Mol Biol

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Background: Male factor infertility that is the cause of about half of the infertility cases, may occur due to azoospermia. Because spermatogenesis defects may lead to non-obstructive azoospermia (NOA), investigating the factors involved in spermatogenesis, including hormones and genes, is one of the most important aspects in understanding the mechanism of NOA in men. Objectives: Male infertility is a complex disorder that affects a large proportion of men, yet many of its causes are unknown. Clarifying its genetic basis may help to identify the causes of infertility and provide effective treatment for patients. Methods: In this case-control study, single nucleotide polymorphisms (SNPs) located in the USP9Y gene were investigated. Accordingly, 100 healthy men and 100 NOA patients were regarded as control and case groups, respectively. Testis tissue samples were taken during the testicular sperm extraction (TESE) procedure, DNA extraction was done, and ARMS PCR was designed and performed. The rs3212292, rs2032597, rs2032604, rs2032598, and rs717268 polymorphisms in the USP9Y gene were analyzed by Tetra-ARMS PCR. Furthermore, the serum levels of sex hormones were assessed by the ELISA technique. Finally, the obtained data were analyzed by SPSS software. Results: According to the obtained results, there was no significant difference in case of genotype frequency of investigated SNPs between the case and control groups (P ≥ 0.05). The mean FSH and LH levels in the control group were relatively lower than the case group (P ≤ 0.05), whereas no significant difference in the mean testosterone level was observed between the two groups (P ≥ 0.05). Conclusions: Polymorphisms of the assessed SNPs showed no effect on the frequency of azoospermia; thus, polymorphisms did not increase the risk of NOA and also did not have a protective effect against the disease. Also, the results showed that the serum levels of FSH and LH increased in NOA patients.

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“…TESA is not the recommended method in these men as it is inefficient and may be traumatic in men with azoospermia. 7 Another method involves testicular sperm extraction through open biopsy (TESE). This method offers a higher sperm retrieval rate than TESA.…”

Section: Introductionmentioning

confidence: 99%

Use of mini‐incision microdissection testicular sperm extraction in men with cryptozoospermia and non‐obstructive azoospermia

2020

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Introduction Microdissection testicular sperm extraction (micro‐TESE) is a procedure commonly utilized to harvest spermatozoa in severe male factor infertility. We have developed a technique involving a mini tunica albuginea incision with superficial tissue dissection (mini‐incision micro‐TESE). The modification is designed to reduce potential tissue injury, and we studied its effectiveness to harvest spermatozoa in men with cryptozoospermia and non‐obstructive azoospermia. Materials and Methods We performed a retrospective analysis of 103 infertile men with NOA and cryptozoospermia who underwent a mini‐incision micro‐TESE between March 2015 and August 2018 at the OVO fertility clinic. We consider the mini‐incision micro‐TESE procedure successful when at least five spermatozoa are identified in the micro‐biopsies obtained from the superficial tissue exposed by the 1‐cm mini‐incision. If no spermatozoa are identified through the mini‐incision, we can easily extend the incision to the standard micro‐TESE. Results The mini‐incision procedure allowed for successful recovery of spermatozoa (intra‐operative recovery of ≥ 5 spermatozoa) in 58% of men with cryptozoospermia and 25.6% of men with NOA. Overall, a successful sperm retrieval (with conversion to conventional micro‐TESE if mini‐incision was not successful) was achieved in 89% of men with cryptozoospermia and 48% of men with NOA. A successful mini‐incision micro‐TESE was associated with a significantly lower number of biopsies than conventional micro‐TESE (8.8 vs 24.2, P < .0001). Moreover, in men undergoing a redo micro‐TESE after a previously successful micro‐TESE, 64% (9/14) had spermatozoa found and 21% (3/14) of these men only required a mini‐incision micro‐TESE. Conclusion Our data suggest that mini‐incision micro‐TESE is a useful approach in men undergoing micro‐TESE, allowing for a shorter incision and a high sperm retrieval rate in men with cryptozoospermia. Furthermore, the findings of our study offer insight into the distribution of spermatogenesis in men with cryptozoospermia and NOA.

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Advances in sperm retrieval techniques in azoospermic men: A systematic review

Cited by 17 publications

References 28 publications

The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis

The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis

The Assessment of 5 Polymorphisms in the USP9Y Gene in Infertile Patients with Non-obstructive Azoospermia

Use of mini‐incision microdissection testicular sperm extraction in men with cryptozoospermia and non‐obstructive azoospermia

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