Human Reproduction, Vol 13, 3075-3080, Copyright © 1998 by Oxford University Press
UI Ezeh, HD Moore and ID Cooke
Little is known about the efficacy and the factors affecting the outcome of
fine needle aspiration biopsy of the testis for sperm retrieval in
azoospermic men with defective spermatogenesis. A prospective study was
designed to compare the efficacy of needle and open (window) testicular
biopsies for testicular epididymal sperm extraction (TESE) in 35
consecutive men with azoospermia due to defective spermatogenesis
undergoing testicular biopsy for intracytoplasmic injection of oocytes.
Each of the consecutive 35 patients underwent TESE using a 19 gauge
butterfly needle followed by a window (1-1.5 cm-sized incision) testicular
biopsy in the same procedure. The extraction of spermatozoa into culture
medium was compared with the assessment of testicular biopsies by
histology, the mode of biopsy (needle or open biopsy) and the amount of
tissue retrieved by either method. Testicular spermatozoa were retrieved in
22 (63%) who had an open testicular biopsy compared with five (14%)
patients who had multiple needle biopsies, respectively; the difference was
statistically significant. Open testicular biopsy retrieves more testicular
tissue than needle biopsy. Needle testicular biopsy retrieved testicular
spermatozoa in 50% of those with hypospermatogenesis, 10% with focal
spermatogenesis and in no patients with maturation arrest or Sertoli
cell-only pattern. In contrast, sperm retrieval was successful in 100%, 90%
and 66% of those with respective histologies using open testicular biopsy.
Other than bruising, for which they required no analgesia, none of the
patients suffered any obvious complications associated with traditional
testicular biopsy. We conclude that open testicular biopsy is more
effective than needle biopsy for the retrieval of testicular spermatozoa in
azoospermic men with defective spermatogenesis. The difference observed may
be related to the amount of testicular tissue retrieved and to the
influence of testicular histology.
ARTICLES
A prospective study of multiple needle biopsies versus a single open biopsy for testicular sperm extraction in men with non-obstructive azoospermia
University Department of Obstetrics and Gynaecology, Jessop Hospital For Women, Sheffield, UK.
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