Microdissection TESE is superior to conventional TESE in patients with nonobstructive azoospermia caused by Y chromosome microdeletions

Schwarzer, Julia; Steinfatt, Heiko; Schleyer, M.; Köhn, F.-M.; Fiedler, K.; Hertwig, Irene von; Krüsmann, G.; Würfel, W.

doi:10.1111/and.12460

Cited by 21 publications

(14 citation statements)

References 8 publications

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“…(), although there are studies showing somehow higher rate of pregnancy 39.4% and 47% (Kim et al., ; Oates et al., ). Of late, Schwarzer et al., and Zhao et al., determined micro‐TESE as the superior procedure for sperm retrieval in AZFc‐deleted azoospermic patients. Current investigations have reported some pregnancies in wives of AZFc‐deleted azoospermic patients (Schwarzer et al., ; Zhao et al., ; Zhu, Wu, Li, Yin, Liu, Song et al., ; Zhu, Wu, Li, Yin, Liu, Wan et al., ), but on the basis of our results, no pregnancy achieved by retrieved sperm in wives of this cohort of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Of late, Schwarzer et al., and Zhao et al., determined micro‐TESE as the superior procedure for sperm retrieval in AZFc‐deleted azoospermic patients. Current investigations have reported some pregnancies in wives of AZFc‐deleted azoospermic patients (Schwarzer et al., ; Zhao et al., ; Zhu, Wu, Li, Yin, Liu, Song et al., ; Zhu, Wu, Li, Yin, Liu, Wan et al., ), but on the basis of our results, no pregnancy achieved by retrieved sperm in wives of this cohort of patients. So despite of sperm retrieval in AZFc‐deleted azoospermic men, the chance of pregnancy or delivery by retrieved sperm was very low.…”

Section: Discussionmentioning

confidence: 99%

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Sperm retrieval rate and reproductive outcome of infertile men with azoospermia factor c deletion

et al. 2018

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To evaluate the success rate in sperm retrieval (SR) through microdissection testicular sperm extraction (micro-TESE) in infertile azoospermia factor c (AZFc)-deleted men and determining their reproductive outcomes following ICSI, medical records of couples with AZFc-deleted male partners were reviewed on patient's age, serum hormone levels, karyotype, testicular pathology and pregnancy outcomes. A comparison on age and serum hormone level was conducted between groups with positive and negative sperm retrieval in both azoospermic and oligozoospermic AZFc-deleted men. Of 225 who had AZFc deletion, 195 cases followed clinical treatments. From 195 cases, 116 were azoospermic, 79 were oligozoospermic. Pathology profile was available in 103 of 195 subjects which the predominant trait was SCOS and was seen in 66.9% of cases (69 of 103). Success rate of sperm retrieval in azoospermic patients who underwent micro-TESE was 36.3% (28/77). Forty-three oligozoospermic and 17 azoospermic patients started ART cycle. Pregnancy rate in oligozoospermic group was 35.4% (17 cases), whilst there was no clinical pregnancy in azoospermic group. In conclusion, the pregnancy and delivery in oligozoospermic patients with AZFc deletion are comparable with other studies, but despite of sperm retrieval in azoospermic patients with AZFc deletion, the chance of pregnancy or delivery in these patients was very low.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sperm retrieval rate and reproductive outcome of infertile men with azoospermia factor c deletion

et al. 2018

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“…Successful sperm retrieval was possible only in patients with isolated AZFc microdeletions. The sperm detection rate for conventional multilobular TESE was 25%, and the sperm detection rate for micro-TESE was significantly higher at67%[ 21 ]. At present, the majority of physicians agree that micro-TESE yields the highest SRR, and that multiple TESE was superior to cTESE.…”

Section: Discussionmentioning

confidence: 99%

A clinical trial on the consistency of bilateral testicular tissue histopathology and Johnsen score: single side or bilateral side biopsy?

et al. 2018

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To evaluate and compare left and right testicular tissue histopathology and Johnsen score, and to investigate the necessity for bilateral testicular biopsy. We recruited180 patients with non-obstructiveazoospermia (NOA) on testicular biopsy who had undergonetesticular sperm aspiration (TESA). Pathological sections of testicular tissue were diagnosed by specially-assigned doctors, who evaluated pathological findings, determined the Johnsen score and confirmed for the presence or absence of sperm. Sperm positive rates for left and right testicular histopathology were 55.0% and 51.7% respectively, and the proportion of Johnsen scores≥8 for left and right testes were 53.3% and 50.0%, respectively. Cohen kappa values revealed that the identification of sperm in bilateral testicular samples was not consistent and was related to random effects; Optimized cut-off value for bilateral testicular volume was 11ml (Johnsen score ≥8), and optimized cut-off values of E2 on left and right testes were 144.5pmol/L and 133.5 pmol/L (Johnsen score≤7). However, age, serum prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH) and total testosterone (TT) levels were not accurate predictors for the existence of testicular sperm. There was nostatistical significance between left and right testicular histopathology in terms of sperm positive rates or Johnsen score; the Johnsen score were caused entirely by random effects and a score from one side could not represent the other side. Therefore, we recommend that both testes need to undergo surgery when NOA patients undergo testicular biopsy or sperm retrieval.

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“…О р и г и н а л ь н а я с т а т ь я Многие авторы указывают, что наличие делеций локуса AZF существенно снижает вероятность обнаружения пригодных для искусственного оплодотворения сперматозоидов при биопсии тестикулярной ткани, при этом принципиальное значение имеет тип делеции. Мы установили, что при микроделециях регионов AZFа, AZFа+b, AZFb+с или AZFа+b+с прогноз для получения сперматозоидов неблагоприятный, что соответствует выводам других авторов [10,22,[27][28][29]31].…”

Section: Discussionunclassified

“…Вероятность получения сперматозоидов с помощью microTESE в среднем в 1,5 раза выше, чем при использовании TESE, и в 2 раза выше, чем при применении TESA, а риск развития осложнений (интратестикулярной гематомы, гипогонадизма, фиброза тканей яичка, острого эпидидимита, гидроцеле) минимальный по сравнению с таковым при других методах [21]. Ретроспективный анализ результатов биопсии тестикулярной ткани пациентов с делециями региона AZFc показал, что эффективность microTESE статистически значимо выше эффективности TESE [22].…”

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Analysis of fertility potential in men with severe azoospermia and oligospermia of various etiology

Yamandi

Акуленко

Safina

et al. 2018

Androl. genit. hir.

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The study objective is to evaluate the significance of the Y chromosome microdeletions for prediction of spermatozoa retrieval during testicle biopsy in men with severe azoospermia and oligozoospermia.Materials and methods. In total, 109 men aged 21 to 56 years (mean age 32.7 ± 0.2 years) with infertility in marriage were examined. Cytogenetic, special andrological, spermiological, and molecular genetic examinations were performed to evaluate non-genetic and genetic causes of infertility.Results. Normal karyotype and absence of AZF deletions were found in 75 men, presence of deletions – in 34. The frequencies of pathozoospermia forms were comparable in these groups. Spermatozoa were retrieved during biopsy in 47 (62.7 %) patients without Y chromosome microdeletions and only in 7 (20.6 %) patients with Y chromosome microdeletions. The men with AZF deletions were divided into 2 subgroups: men with complete AZF region deletions (n = 25) and men with partial AZF deletions (n = 9). Among men with complete deletions, azoospermia was diagnosed in 25 (100 %), spermatozoa were retrieved during biopsy in 2 (8 %); among men with partial deletions, azoospermia was diagnosed in 7 (77.8 %), severe oligozoospermia in 2 (22.2 %), spermatozoa were retrieved during biopsy in 5 (56 %). Then the patients were divided according to another criterion: 54 patients from whom spermatozoa were retrieved during biopsy and 55 men with negative results. Among patients with successful result of biopsy, Y chromosome microdeletions were identified in 7 (13 %); among patient with negative biopsy result – in 27 (49 %) (р < 0.01).Conclusion. Success rate of spermatozoa retrieval during testicle biopsy is significantly higher in men without AZF deletions (р < 0.01) than in men with deletions. Molecular genetic examination of Y chromosome microdeletions is recommended for men with azoospermia and severe oligozoospermia because it allows diagnosing of cause male infertility and predicting.

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Microdissection TESE is superior to conventional TESE in patients with nonobstructive azoospermia caused by Y chromosome microdeletions

Cited by 21 publications

References 8 publications

Sperm retrieval rate and reproductive outcome of infertile men with azoospermia factor c deletion

Sperm retrieval rate and reproductive outcome of infertile men with azoospermia factor c deletion

A clinical trial on the consistency of bilateral testicular tissue histopathology and Johnsen score: single side or bilateral side biopsy?

Analysis of fertility potential in men with severe azoospermia and oligospermia of various etiology

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