Abstract
In this study, we aimed to investigate the effect of testicular biopsy on the success rate of microdissection testicular sperm extraction (mTESE) in patients with non-obstructive azoospermia (NOA).
The data of patients who underwent mTESE between 1999 and 2019 in our clinic were retrospectively analyzed. Sperm retrieval rate (SRR), demographic and clinical data of the patients with pathology reports were compiled. Using SPSS v.25 (Armonk, NY: IBM Corp.), pathology data and SRR of the patients who underwent mTESE were analyzed comparatively.
A total of 377 patients who underwent mTESE operation between the specified dates in our clinic and satisfied the exclusion and inclusion criteria were included in the study. Of the patients, 321 had primary, and 56 had secondary mTESE. Of the primary mTESE patients, the pathology reports revealed as hypospermatogenesis, maturation arrest, Sertoli cell-only (SCO) syndrome, Leydig cell hyperplasia, and normal testicular tissue were 66 (20.5%), 88 (27.4%), 127 (39.5%), 23 (7.1%), 17 (5.3%), respectively. SRR was %51 in primary mTESE. In subgroup analysis, the lowest SRR was found in SCO pathology at 21.3%. In the pathology data of patients who underwent secondary mTESE, the rates of hypospermatogenesis, maturation arrest, SCO, Leydig cell hyperplasia, and normal testicular tissue were recorded as 11 (19.6%), 16 (28.5%), 1 (1.8%), and 3 (5.4%), respectively. The SRR of all secondary mTESE patients was 38%. In the subgroup analysis, the lowest SRRs were found in SCO and Leydig cell hyperplasia groups (6.3% and 0%, respectively) (Table).
According to our results, Leydig cell hyperplasia, hypospermatogenesis, and maturation arrest pathologies showed higher SRR than the general average in patients who underwent primary mTESE. The SCO group appears to have the least favorable outcomes, as indicated by the lowest observed SRR. Patients should be informed prior to the secondary mTESE based on the pathologic data, and further treatments that improve outcomes might be suggested.
All authors declare that they have no conflicts of interest.
