Document Detail

Diagnostic epididymal and testicular sperm recovery and genetic aspects in azoospermic men.
MedLine Citation:
PMID:  10374107     Owner:  NLM     Status:  MEDLINE    
Various procedures for sperm recovery in azoospermic men have been described, from open testicular biopsy to simple needle aspiration from the epididymis and the testis. Fifty-one obstructive and 86 non-obstructive azoospermic men were treated to compare the recovery of spermatozoa obtained by percutaneous aspiration from the epididymis (PESA) and aspiration/extraction from the testis (TESA, TESE) with histopathology. If TESA failed, the work up proceeded with TESE. All patients were karyotyped. Spermatozoa were recovered by PESA or TESA in all obstructive men (51/51 patients). In 22 out of 86 patients with non-obstructive azoospermia, testicular spermatozoa could be successfully recovered by TESA. In five additional patients TESE was successful in recovering spermatozoa where TESA had failed. In 43 patients, neither TESA nor TESE was successful. Sixteen patients chose not to proceed with TESE. Seven out of 86 patients had an abnormal karyotype in the non-obstructive group (8%), none in the obstructive group. In the non-obstructive patient group testicular histopathology showed hypospermatogenesis, incomplete maturation arrest and germ cell aplasia with focal spermatogenesis in cases where spermatozoa were recovered and complete germ cell aplasia, complete maturation arrest and fibrosis in cases where no spermatozoa were found. Spermatozoa were recovered by PESA or TESA from all patients with obstructive azoospermia and from approximately 40% of patients with non-obstructive azoospermia by TESA or TESE. Retrieval of viable spermatozoa in the infertility work-up was highly predictable for sperm recovery in subsequent ICSI cycles. TESA performed under local anaesthesia seems almost as effective as more invasive procedures in recovering testicular spermatozoa, both in obstructive and non-obstructive azoospermic men.
G Westlander; L Hamberger; C Hanson; K Lundin; L Nilsson; B Söderlund; C Werner; C Bergh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  14     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-07-29     Completed Date:  1999-07-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  118-22     Citation Subset:  IM    
Centre for Reproductive Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden.
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MeSH Terms
Oligospermia / genetics*,  pathology,  physiopathology
Specimen Handling* / methods
Sperm Maturation / physiology
Sperm Motility / physiology
Spermatogenesis / physiology
Spermatozoa* / pathology

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