The First Report from Harran University Department of Urology on Microscopic Testicular Sperm extraction Results in Non-obstructive Azoospermic Patients

Year 2019, Volume: 16 Issue: 1, 134 - 138, 22.03.2019

Eyyup Sabri Pelit , Halil Çiftçi

Abstract

Background: Microscopic testicular sperm extraction (micro-TESE) is the technique with the highest sperm retrieval rate for intracytoplasmic sperm injection. The aim of this study is to present our experience in micro-TESE and to assess the relationship between sperm retrieval rate and patient characteristics, testicular functions as well as previous sperm retrieval.

Methods: We retrospectively investigated 83 non-obstructive azoospermic patients who underwent micro-TESE between 2017-2018. All procedures were performed by a single surgeon under regional anesthesia using the microscope (Karl Zeiss, Germany) the 18-22 magnification in our clinic’s operating room. Follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone levels, karyotype analysis, Y microdeletions and testicular volume scrotal ultrasonography scale were recorded. The obtained sperm cells were subjected to cryopreservation. Furthermore, ICSI procedure was performed by use of the obtained sperm cells in another session.

Results: A total of 83 patients were included in the study. The mean age of the patients was 27.7 ± 5 years. The mean age of micro-TESE positive patients was 26.8 ± 6, and the mean age of those with negative TESE was 28.3 ± 5. The mean duration of infertility was 5.2 ± 3.5 years. Overall sperm retrieval rate was 51.8% (43). Age of the patients, testicular size, serum FSH, LH and testosterone did not show any statistically significance on sperm retrieval rates.

Conclusion: Micro-TESE is the most accurate and successful method of surgically retrival of sperm cells in non- obstructive azoospermic patients. Our results are consistent with the rates of reference centers.

Keywords

Micro-TESE, Infertility, Azospermia

Non-obstrüktif Azospermik Hastalarda Mikrocerrahi Testiküler Sperm Ekstraksiyonu İlk Sonuçlarımız: Harran Üniversitesi Üroloji Kliniği

Abstract

Amaç: Mikroskopik testiküler sperm ekstraksiyonu (mikro-TESE), intrasitoplazmik sperm enjeksiyonu için sperm bulma oranı en yüksek olan tekniktir. Bu çalışmanın amacı, mikro-TESE'deki deneyimlerimizi sunmak ve önceki sperm alım müdahalelerinin yanı sıra, sperm bulma oranı ile hastaların özellikleri, testis fonksiyonları ilişkisini değerlendirmektir.

Materyal ve Method: 2017-2018 yılları arasında mikro-TESE yapılan 83 non-obstrüktif azoospermi hastalarını retrospektif olarak inceledik. Tüm işlemler rejyonel anestezi altında kliniğimiz ameliyathanesinde mikroskop altında 18-22 büyütme kullanılarak (Karl Zeiss, Almanya) tek cerrah tarafından yapıldı. Folikül stimüle edici hormon (FSH), luteinize edici hormon (LH), total testosteron seviyeleri, karyotip analizi, Y mikrodelesyonları ve testiküler hacim skrotal ultrasonografi skalası ile ölçülüp veriler kayıt edildi. Elde edilen sperm hücreleri kriyo-prezervasyona tabi tutuldu. İntrasitoplazmik sperm enjeksiyonu (ICSI) prosedürü elde edilen sperm hücreleri kullanılarak başka seansta gerçekleştirilecektir.

Bulgular: Çalışmaya toplam 83 hasta dahil edildi. Hastaların ortalama yaşı 27,7±5 olarak bulundu. Mikro-TESE pozitif olan hastaların ortalama yaşı 26,8±6, negatif olanların ortalama yaşı 28,3±5 olarak saptandı. Ortalama infertilite süresi 5,2 ± 3,5 yıldı. Genel sperm elde etme oranı %51,8 (43) idi. Hastaların yaşı, testiküler boyut, serum FSH, LH ve testosteron düzeyleri sperm elde etme oranları üzerinde anlamlı bir etki göstermedi.

Sonuç: Micro-TESE, non- obstrüktif azoospermik hastalarda cerrahi olarak sperm hücrelerini almanın en kesin ve başarılı yöntemidir. Sonuçlarımız referans merkezlerinin oranları ile paraleldir.

Keywords

Mikro-TESE, İnfertilite, Azospermi

References

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