Conventional TESE technique: A short review and a single-centre experience in 9 years

Abstract

Infertility is defined as the inability of a sexually active, non-contraceptive couple to achieve spontaneous pregnancy within one year (Word Health Organisation). It is estimated that there are 15-20% of infertile couples, and this number is increasing, making infertility a major socio-demographic global problem. In the past, female factors were thought to be the main causes, but today we know that male infertility accounts for about 50% of cases. Therefore, simultaneous treatment of both sexes is recommended. The most severe condition of male infertility is azoospermia, which occurs in the general population in 1%, while in infertile male populations it occurs in 10-20% of cases. Azoospermia can be obstructive (OA) and non-obstructive (NOA). Among various treatment options for azoospermia, testicular biopsy (TESE) provides the best chance of sperm retrieval. TESE can be done by classical (conventional, open) approach or using an operating microscope, microsurgical TESE (mTESE). mTESE is reserved for the most complex patients with genetic disorders or previously sperm retrieval failure during conventional TESE procedure.

Leydig Cells in Patients with Non-Obstructive Azoospermia: Do They Really Proliferate?

“…As a tertiary andrological centre, we deal with the most difficult cases of infertility. Almost 90% of patients with azoospermia in our centre are NOA cases [38], where parenchyma re-modelling and fibrosis is profound.…”