Microdissection testicular sperm extraction in non-obstructive azoospermic patients with solitary testis: a retrospective case-control study

Extracción de espermatozoides testiculares por microdisección en pacientes azoospérmicos no obstructivos con testículo solitario: un estudio retrospec-tivo de casos y controles

Obtaining sperm from the testis surgically and using these sperm with the intracytoplasmic sperm injection technique, has opened the way for the possibility of biological fathering in men with non-obstructive azoospermia (NOA). We aimed to evaluate our sperm retrieval rate (SRR) by microdissection testicular sperm extraction (micro-TESE) in NOA patients with solitary testis. In this retrospective case-control study, forty-five patients with NOA who had a congenital or acquired solitary testis were included, between September 2003 and January 2022. These patients were randomly matched with patients with NOA who had bilateral testes, using a 1:3 matching ratio. We found that SRR by micro-TESE in patients with solitary testis was similar to NOA patients with bilateral testis (51.1% vs. 50.4%). Age, infertility period, ejaculate volume, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone, history of varicocelectomy, history of orchiopexy, testicular stimulation therapy before micro-TESE, testicular volume, genetic status, TESE side, micro-TESE success, complications and histopathological evaluation results of both groups were evaluated, there was a statistically significant difference in only serum FSH and LH levels. There was no difference between the groups in terms of complications and hormonal effects in the early postoperative period. Micro-TESE in NOA patients with solitary testis has similar sperm retrieval and complication rates as NOA patients with bilateral testis.

Resumen

Obtener espermatozoides quirúrgicamente del testículo y utilizar estos espermatozoides con la técnica de inyección intracitoplasmática de espermatozoides ha abierto la posibilidad de la paternidad biológica en hombres con azoospermia no obstructiva (ANO). Nuestro objetivo fue evaluar nuestra tasa de recuperación de espermatozoides (TRE) mediante la extracción microscópica de espermatozoides testiculares (micro-TESE) en pacientes con ANO y testículo único. En este estudio de casos y controles retrospectivo, se incluyeron cuarenta y cinco pacientes con ANO que tenían un testículo único congénito o adquirido, entre septiembre de 2003 y enero de 2022. Estos pacientes fueron emparejados al azar con pacientes con ANO que tenían testículos bilaterales, utilizando una proporción de emparejamiento de 1:3. Hemos observado que la TRE mediante micro-TESE en pacientes con testículo único fue similar a la de pacientes con ANO que tenían testículos bilaterales (51.1% vs. 50.4%). Se evaluaron la edad, el período de infertilidad, el volumen de eyaculado, los niveles séricos de FSH, LH y testosterona, antecedentes de varicocelectomía, historial de orquiopexia, terapia de estimulación testicular antes de micro-TESE, volumen testicular, estado genético, lado de la TESE, éxito de la micro-TESE, complicaciones y resultados de la evaluación histopatológica en ambos grupos. Solo hubo una diferencia estadísticamente significativa en los niveles séricos de FSH y LH. No hubo diferencia entre los grupos en términos de complicaciones y efectos hormonales en el periodo postoperatorio temprano. Micro-TESE en pacientes con ANO y testículo único presenta tasas de recuperación de espermatozoides y complicaciones similares a las de pacientes con ANO y testículos bilaterales.

Azoospermia; Testis; Sperm retrieval

Palabras Clave

Azoospermia; Testículos; Recuperación de espermatozoides

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