Document Detail


Which is the best sperm retrieval technique for non-obstructive azoospermia? A systematic review.
MedLine Citation:
PMID:  17895238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Our objective was to establish which is the best sperm retrieval technique in non-obstructive azoospermia based on the available evidence. To date, no randomized controlled trial has compared the efficiency of these strategies and thus current recommendations are based on cumulative evidence provided by descriptive, observational and controlled studies. Three outcome measures were assessed for the sperm retrieval techniques: sperm retrieval rate (SRR), complications and live birth rate. Twenty-four descriptive studies reporting on the results of testicular sperm extraction (TESE) were encountered. Seven controlled studies that compared microdissection (MD) TESE with conventional TESE and seven controlled studies comparing fine needle testicular aspiration (FNA) with TESE were identified. The mean SRR for TESE was 49.5% (95% CI 49.0-49.9). TESE with multiple biopsies results in a higher SRR than FNA especially in cases of Sertoli-cell-only (SCO) syndrome and maturation arrest. Current evidence suggests that MD performs better than conventional TESE only in cases of SCO where tubules containing active focus of spermatogenesis can be identified. MD appears to be the safest technique regarding post-operative complications followed by FNA. Only three studies could be identified concerning the influence of the sperm retrieval technique on clinical pregnancy and live birth rate, hence no definitive conclusions can be made. However, so far there appears to be no impact of the technique itself on success rates.
Authors:
P Donoso; H Tournaye; P Devroey
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-09-24
Journal Detail:
Title:  Human reproduction update     Volume:  13     ISSN:  1355-4786     ISO Abbreviation:  Hum. Reprod. Update     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-10-17     Completed Date:  2008-02-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9507614     Medline TA:  Hum Reprod Update     Country:  England    
Other Details:
Languages:  eng     Pagination:  539-49     Citation Subset:  IM    
Affiliation:
Reproductive Medicine Unit, Clinica Alemana, Vitacura 5951, Santiago, Chile. pdonoso@alemana.cl
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MeSH Terms
Descriptor/Qualifier:
Azoospermia / therapy*
Female
Humans
Male
Pregnancy
Pregnancy Rate
Sperm Retrieval* / adverse effects,  statistics & numerical data

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