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Human Reproduction, Vol. 16, No. 12, 2621-2627, December 2001
© 2001 European Society of Human Reproduction and Embryology

Serial ultrasonography, hormonal profile and antisperm antibody response after testicular sperm aspiration

Göran Westlander1,3, Erling Ekerhovd1, Seth Granberg1, Nils Lycke2, Lars Nilsson1, Charlotte Werner1 and Christina Bergh1

1 Centre for Reproductive Medicine and 2 Department of Clinical Immunology, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden

BACKGROUND: In many fertility centres, intracytoplasmic sperm injection (ICSI) with epididymal or testicular spermatozoa is a routine treatment for men with azoospermia. In this prospective study, the physiological consequences after testicular sperm aspiration (TESA), using suction and a 19 gauge needle, were evaluated. METHODS AND RESULTS: Thirty-five consecutive men with azoospermia underwent TESA. Testicular ultrasonography with Doppler flow imaging was performed and testicular volumes were evaluated pre-operatively and 3 months after aspiration. If focal testicular lesions were found, further examinations were performed 6 and 9 months after TESA. Serum FSH, testosterone and antisperm antibodies (ASA) were analysed. Focal testicular lesions were seen in four out of 61 testes (6.6%) at the 3 month investigation point. Three lesions were resolved after 6 months and all after 9 months. Testicular echogenicity remained unchanged in 50 cases (82%) 3 months after TESA. Four men (11.4%) reported severe subjective discomfort post-operatively, but only one had a medical consultation where an intratesticular haematoma was diagnosed. There were no significant changes in FSH and testosterone after surgery and testicular volumes were similar after 3 months. There were three borderline cases of ASA in serum, but none was classified as ASA-positive. CONCLUSIONS: The puncture method of testicular sperm aspiration seems to be a safe method for sperm retrieval, with minimal physiological consequences.

Key words: antisperm antibodies/azoospermia/male infertility/testicular sperm aspiration/ultrasonography

3 To whom correspondence should be addressed at: Centre for Reproductive Medicine, Sahlgrenska University Hospital, Göteborg University, SE-413 45 Göteborg, Göteborg, Sweden. E-mail: goran.westlander{at}medfak.gu.se


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