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The First Report from Harran University Department of Urology on Microscopic Testicular Sperm extraction Results in Non-obstructive Azoospermic Patients

Year 2019, Volume: 16 Issue: 1, 134 - 138, 22.03.2019

Abstract

Background: Microscopic testicular sperm extraction (micro-TESE) is the technique with the highest sperm retrieval rate for intracytoplasmic sperm injection. The aim of this study is to present our experience in micro-TESE and to assess the relationship between sperm retrieval rate and patient characteristics, testicular functions as well as previous sperm retrieval.

Methods: We retrospectively investigated 83 non-obstructive azoospermic patients who underwent micro-TESE between 2017-2018. All procedures were performed by a single surgeon under regional anesthesia using the microscope (Karl Zeiss, Germany) the 18-22 magnification in our clinic’s operating room. Follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone levels, karyotype analysis, Y microdeletions and testicular volume scrotal ultrasonography scale were recorded. The obtained sperm cells were subjected to cryopreservation. Furthermore, ICSI procedure was performed by use of the obtained sperm cells in another session.

Results: A total of 83 patients were included in the study. The mean age of the patients was 27.7 ± 5 years. The mean age of micro-TESE positive patients was 26.8 ± 6, and the mean age of those with negative TESE was 28.3 ± 5. The mean duration of infertility was 5.2 ± 3.5 years. Overall sperm retrieval rate was 51.8% (43). Age of the patients, testicular size, serum FSH, LH and testosterone did not show any statistically significance on sperm retrieval rates.

Conclusion: Micro-TESE is the most accurate and successful method of surgically retrival of sperm cells in non- obstructive azoospermic patients. Our results are consistent with the rates of reference centers.

References

  • 1. Willott GM. Frequency of azoospermia. Forensic Sci Int. 1982;20:9–10.2. Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol. 1989;142:62–5.3. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillensjü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod. 1998;13:1266–71.4. Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Reprod. 2000;15:653–6. 5. Tournaye H. Surgical sperm recovery for intracytoplasmic sperm injection: Which method is to be preferred? Hum Reprod. 1999;14:71–81.6. Schlegel PN. Testicular sperm extraction: Microdissection improves sperm yield with minimal tissue excision. Hum Reprod. 1999;14:131–5. 7. Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Reprod. 2000;15:653–6. 8. Friedler S, Raziel A, Strassburger D, Soffer Y, Komarovsky D, Ron-El R. Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Reprod. 1997;12:1488–93. 9. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillensjü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod. 1998;13:1266–71. 10. Tsujimura A, Miyagawa Y, Takao T, Takada S, Koga M, Takeyama M, et al. Salvage microdissection testicular sperm extraction after failed conventional testicular sperm extraction in patients with nonobstructive azoospermia. J Urol. 2006;175:1446–9. 11. Everaert K, De Croo I, Kerckhaert W, Dekuyper P, Dhont M, Van der Elst J, et al. Long term effects of micro-surgical testicular sperm extraction on androgen status in patients with non obstructive azoospermia. BMC Urol. 2006;6:9. 12. Moon MH, Kim SH, Cho JY, Seo JT, Chun YK. Scrotal US for evaluation of infertile men with azoospermia. Radiology. 2006;239:168–73. 13. Bryson CF, Ramasamy R, Sheehan M, Palermo GD, Rosenwaks Z, et al. Severe testicular atrophy does not affect the success of microdissection testicular sperm extraction. J Urol. 2014;191:175–8.14. Zitzmann M, Nordhoff V, von Schonfeld V, Nordsiek-Mengede A, Kliesch S, Schuring AN, et al. Elevated follicle-stimulating hormone levels and the chances for azoospermic men to become fathers after retrieval of elongated spermatids from cryopreserved tes¬ticular tissue. Fertil Steril. 2006; 86(2):339-347. 15. Hauser R, Temple-Smith PD, Southwick GJ, de Kretser D. Fertility in cases of hypergo-nadotropic azoospermia. Fertil Steril. 1995; 63(3):631-636.
  • 16. Ishikawa T. Surgical recovery of sperm in non-obstructive azoospermia. Asian J Androl. 2012;14:109–15. 17. Jezek D, Knuth UA, Schulze W. Successful testicular sperm extraction (TESE) in spite of high serum follicle stimulating hormone and azoospermia: correlation between testicular morphology, TESE results, semen analysis and serum hormone values in 103 infertile men. Hum Reprod. 1998;13:1230–4. 18. Ezeh UI, Taub NA, Moore HD, Cooke ID. Establishment of predictive variables associated with testicular sperm retrieval in men with non-obstructive azoospermia. Hum Reprod. 1999;14:1005–12.19. Silber SJ, van Steirteghem A, Nagy Z, Liu J, Tournaye H, et al. Normal pregnancies resulting from testicular sperm extraction and intracytoplasmic sperm injection for azoospermia due to maturation arrest. Fertil Steril. 1996;66:110–7.20. Aksglaede L, Wikström AM, Rajpert-De Meyts E, Dunkel L, Skakkebaek NE, Juul A. Natural history of seminiferous tubule degeneration in Klinefelter syndrome. Hum Reprod Update. 2006;12(1):39–48.21. Foresta C, Galeazzi C, Bettella A, Marin P, Rossato M, Garolla A, et al. Analysis of meiosis in intratesticular germ cells from subjects affected by classic Klinefelter's syndrome. J Clin Endocrinol Metab. 1999;84(10):3807–3810. 22. Harari O, Bourne H, Baker G, Gronow M, Johnston I. High fertilization rate with intracytoplasmic sperm injection in mosaic Klinefelter's syndrome. Fertil Steril. 1995;63(1):182–184.23. Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. Sperm chromosome analysis and outcome of IVF in patients with non-mosaic Klinefelter's syndrome. Fertil Steril. 2000;74(5):925–929.24. Yarali H, Polat M, Bozdag G, Gunel M, Alpas I, Esinler I, et al. TESE-ICSI in patients with non-mosaic Klinefelter syndrome: a comparative study. Reprod Biomed Online. 2009;18(6):756–760.25. Madureira C, Cunha M, Sousa M, Neto A, Pinho M, Viana P, et al. Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children. Andrology. 2014;2(4):623–631.
  • 1. Willott GM. Frequency of azoospermia. Forensic Sci Int. 1982;20:9–10. 2. Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol. 1989;142:62–5. 3. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillens-jü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Rep-rod. 1998;13:1266–71. 4. Amer M, Ateyah A, Hany R, Zohdy W. Prospective compara-tive study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Rep-rod. 2000;15:653–6. 5. Tournaye H. Surgical sperm recovery for intracytoplasmic sperm injection: Which method is to be preferred? Hum Rep-rod. 1999;14:71–81. 6. Schlegel PN. Testicular sperm extraction: Microdissection improves sperm yield with minimal tissue excision. Hum Rep-rod. 1999;14:131–5. 7. Amer M, Ateyah A, Hany R, Zohdy W. Prospective compara-tive study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Rep-rod. 2000;15:653–6. 8. Friedler S, Raziel A, Strassburger D, Soffer Y, Komarovsky D, Ron-El R. Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azo-ospermia. Hum Reprod. 1997;12:1488–93. 9. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillens-jü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Rep-rod. 1998;13:1266–71. 10. Tsujimura A, Miyagawa Y, Takao T, Takada S, Koga M, Takeyama M, et al. Salvage microdissection testicular sperm extraction after failed conventional testicular sperm extraction in patients with nonobstructive azoospermia. J Urol. 2006;175:1446–9. 11. Everaert K, De Croo I, Kerckhaert W, Dekuyper P, Dhont M, Van der Elst J, et al. Long term effects of micro-surgical testi-cular sperm extraction on androgen status in patients with non obstructive azoospermia. BMC Urol. 2006;6:9. 12. Moon MH, Kim SH, Cho JY, Seo JT, Chun YK. Scrotal US forevaluation of infertile men withazoosper-mia. Radiology. 2006;239:168–73. 13. Bryson CF, Ramasamy R, Sheehan M, Palermo GD, Ro-senwaks Z, et al. Severe testicularatrophydoes not af-fectthesuccess of microdissectiontesticular sperm extrac-tion. J Urol. 2014;191:175–8. 14. Zitzmann M, Nordhoff V, von Schonfeld V, Nordsiek-Mengede A, Kliesch S, Schuring AN, et al. Elevated follicle-stimulating hormone levels and the chances for azoospermic men to become fathers after retrieval of elongated sperma-tids from cryopreserved tes¬ticular tissue. FertilSteril. 2006; 86(2):339-347. 15. Hauser R, Temple-Smith PD, Southwick GJ, de Kretser D. Fertility in cases of hypergo¬nadotropic azoospermia. Fer-tilSteril. 1995; 63(3):631-636. 16. Ishikawa T. Surgicalrecovery of sperm in non-obstructiveazoospermia. Asian J Androl. 2012;14:109–15. 17. Jezek D, Knuth UA, Schulze W. Successfultesticular sperm extraction (TESE) in spite of high serum folliclestimulating-hormoneandazoospermia: correlationbetweentesticularmorp-hology, TESE results, semen analysisand serum hormoneva-lues in 103 infertile men. Hum Reprod. 1998;13:1230–4. 18. Ezeh UI, Taub NA, Moore HD, Cooke ID. Establishment of predictivevariablesassociatedwithtesticular sperm retrieval in men withnon-obstructiveazoospermia. Hum Rep-rod. 1999;14:1005–12. 19. Silber SJ, vanSteirteghem A, Nagy Z, Liu J, Tournaye H, et al. Normal pregnanciesresultingfromtesticular sperm extracti-onandintracytoplasmic sperm injectionforazoospermiadueto-maturationarrest. Fertil Steril. 1996;66:110–7. 20. Aksglaede L, Wikström AM, Rajpert-De Meyts E, Dunkel L, Skakkebaek NE, Juul A. Natural history of seminiferoustubu-ledegeneration in Klinefeltersyndrome. Hum Reprod Upda-te. 2006;12(1):39–48. 21. Foresta C, Galeazzi C, Bettella A, Marin P, Rossato M, Garol-la A, et al. Analysis of meiosis in intratesticulargermcellsfrom-subjectsaffectedbyclassicKlinefelter'ssyndrome. J ClinEndoc-rinolMetab. 1999;84(10):3807–3810. 22. Harari O, Bourne H, Baker G, Gronow M, Johnston I. High fertilization rate withintracytoplasmic sperm injection in mo-saicKlinefelter'ssyndrome. Fertil Steril. 1995;63(1):182–184. 23. Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. Sperm chromosomeanalysisandoutcome of IVF in pa-tientswithnon-mosaicKlinefelter'ssyndrome. Fertil Ste-ril. 2000;74(5):925–929. 24. Yarali H, Polat M, Bozdag G, Gunel M, Alpas I, Esinler I, et al. TESE-ICSI in patientswithnon-mosaicKlinefeltersyndrome: a comparativestudy. ReprodBiomed Online. 2009;18(6):756–760. 25. Madureira C, Cunha M, Sousa M, Neto A, Pinho M, Viana P, et al. Treatmentbytesticular sperm extractionandintracytop-lasmic sperm injection of 65 azoospermicpatientswithnon-mosaicKlinefeltersyndromewithbirth of 17 healthychild-ren. Andrology. 2014;2(4):623–631. 26. Reifsnyder JE, Ramasamy R, Husseini J, Schlegel PN. Role of optimizing testosterone before microdissection testicular sperm extraction in men with nonobstructive azoosper¬mia. The Journal of urology. 2012; 188(2):532-536. 27. Ramasamy R, Sterling J, Fisher ES, Li PS, Jain M, Robinson BD, et al. Identification of spermatogenesis with multiphoton microscopy: An evaluation in a rodent model. J Urol. 2011;186:2487–92. 28. Ramasamy R, Sterling J, Manzoor M, Salamoon B, Jain M, Fisher E, et al. Full field optical coherence tomography can identify spermatogenesis in a rodent sertoli-cell only model. J Pathol Inform. 2012;3:4.

Non-obstrüktif Azospermik Hastalarda Mikrocerrahi Testiküler Sperm Ekstraksiyonu İlk Sonuçlarımız: Harran Üniversitesi Üroloji Kliniği

Year 2019, Volume: 16 Issue: 1, 134 - 138, 22.03.2019

Abstract

Amaç: Mikroskopik testiküler sperm ekstraksiyonu (mikro-TESE), intrasitoplazmik sperm enjeksiyonu için sperm bulma oranı en yüksek olan tekniktir. Bu çalışmanın amacı, mikro-TESE'deki deneyimlerimizi sunmak ve önceki sperm alım müdahalelerinin yanı sıra, sperm bulma oranı ile hastaların özellikleri, testis fonksiyonları ilişkisini değerlendirmektir.

Materyal ve Method: 2017-2018 yılları arasında mikro-TESE yapılan 83 non-obstrüktif azoospermi hastalarını retrospektif olarak inceledik. Tüm işlemler rejyonel anestezi altında kliniğimiz ameliyathanesinde mikroskop altında 18-22 büyütme kullanılarak (Karl Zeiss, Almanya) tek cerrah tarafından yapıldı. Folikül stimüle edici hormon (FSH), luteinize edici hormon (LH), total testosteron seviyeleri, karyotip analizi, Y mikrodelesyonları ve testiküler hacim skrotal ultrasonografi skalası ile ölçülüp veriler kayıt edildi. Elde edilen sperm hücreleri kriyo-prezervasyona tabi tutuldu. İntrasitoplazmik sperm enjeksiyonu (ICSI) prosedürü elde edilen sperm hücreleri kullanılarak başka seansta gerçekleştirilecektir.

Bulgular: Çalışmaya toplam 83 hasta dahil edildi. Hastaların ortalama yaşı 27,7±5 olarak bulundu. Mikro-TESE pozitif olan hastaların ortalama yaşı 26,8±6, negatif olanların ortalama yaşı 28,3±5 olarak saptandı. Ortalama infertilite süresi 5,2 ± 3,5 yıldı. Genel sperm elde etme oranı %51,8 (43) idi. Hastaların yaşı, testiküler boyut, serum FSH, LH ve testosteron düzeyleri sperm elde etme oranları üzerinde anlamlı bir etki göstermedi.

Sonuç: Micro-TESE, non- obstrüktif azoospermik hastalarda cerrahi olarak sperm hücrelerini almanın en kesin ve başarılı yöntemidir. Sonuçlarımız referans merkezlerinin oranları ile paraleldir.

References

  • 1. Willott GM. Frequency of azoospermia. Forensic Sci Int. 1982;20:9–10.2. Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol. 1989;142:62–5.3. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillensjü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod. 1998;13:1266–71.4. Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Reprod. 2000;15:653–6. 5. Tournaye H. Surgical sperm recovery for intracytoplasmic sperm injection: Which method is to be preferred? Hum Reprod. 1999;14:71–81.6. Schlegel PN. Testicular sperm extraction: Microdissection improves sperm yield with minimal tissue excision. Hum Reprod. 1999;14:131–5. 7. Amer M, Ateyah A, Hany R, Zohdy W. Prospective comparative study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Reprod. 2000;15:653–6. 8. Friedler S, Raziel A, Strassburger D, Soffer Y, Komarovsky D, Ron-El R. Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azoospermia. Hum Reprod. 1997;12:1488–93. 9. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillensjü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Reprod. 1998;13:1266–71. 10. Tsujimura A, Miyagawa Y, Takao T, Takada S, Koga M, Takeyama M, et al. Salvage microdissection testicular sperm extraction after failed conventional testicular sperm extraction in patients with nonobstructive azoospermia. J Urol. 2006;175:1446–9. 11. Everaert K, De Croo I, Kerckhaert W, Dekuyper P, Dhont M, Van der Elst J, et al. Long term effects of micro-surgical testicular sperm extraction on androgen status in patients with non obstructive azoospermia. BMC Urol. 2006;6:9. 12. Moon MH, Kim SH, Cho JY, Seo JT, Chun YK. Scrotal US for evaluation of infertile men with azoospermia. Radiology. 2006;239:168–73. 13. Bryson CF, Ramasamy R, Sheehan M, Palermo GD, Rosenwaks Z, et al. Severe testicular atrophy does not affect the success of microdissection testicular sperm extraction. J Urol. 2014;191:175–8.14. Zitzmann M, Nordhoff V, von Schonfeld V, Nordsiek-Mengede A, Kliesch S, Schuring AN, et al. Elevated follicle-stimulating hormone levels and the chances for azoospermic men to become fathers after retrieval of elongated spermatids from cryopreserved tes¬ticular tissue. Fertil Steril. 2006; 86(2):339-347. 15. Hauser R, Temple-Smith PD, Southwick GJ, de Kretser D. Fertility in cases of hypergo-nadotropic azoospermia. Fertil Steril. 1995; 63(3):631-636.
  • 16. Ishikawa T. Surgical recovery of sperm in non-obstructive azoospermia. Asian J Androl. 2012;14:109–15. 17. Jezek D, Knuth UA, Schulze W. Successful testicular sperm extraction (TESE) in spite of high serum follicle stimulating hormone and azoospermia: correlation between testicular morphology, TESE results, semen analysis and serum hormone values in 103 infertile men. Hum Reprod. 1998;13:1230–4. 18. Ezeh UI, Taub NA, Moore HD, Cooke ID. Establishment of predictive variables associated with testicular sperm retrieval in men with non-obstructive azoospermia. Hum Reprod. 1999;14:1005–12.19. Silber SJ, van Steirteghem A, Nagy Z, Liu J, Tournaye H, et al. Normal pregnancies resulting from testicular sperm extraction and intracytoplasmic sperm injection for azoospermia due to maturation arrest. Fertil Steril. 1996;66:110–7.20. Aksglaede L, Wikström AM, Rajpert-De Meyts E, Dunkel L, Skakkebaek NE, Juul A. Natural history of seminiferous tubule degeneration in Klinefelter syndrome. Hum Reprod Update. 2006;12(1):39–48.21. Foresta C, Galeazzi C, Bettella A, Marin P, Rossato M, Garolla A, et al. Analysis of meiosis in intratesticular germ cells from subjects affected by classic Klinefelter's syndrome. J Clin Endocrinol Metab. 1999;84(10):3807–3810. 22. Harari O, Bourne H, Baker G, Gronow M, Johnston I. High fertilization rate with intracytoplasmic sperm injection in mosaic Klinefelter's syndrome. Fertil Steril. 1995;63(1):182–184.23. Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. Sperm chromosome analysis and outcome of IVF in patients with non-mosaic Klinefelter's syndrome. Fertil Steril. 2000;74(5):925–929.24. Yarali H, Polat M, Bozdag G, Gunel M, Alpas I, Esinler I, et al. TESE-ICSI in patients with non-mosaic Klinefelter syndrome: a comparative study. Reprod Biomed Online. 2009;18(6):756–760.25. Madureira C, Cunha M, Sousa M, Neto A, Pinho M, Viana P, et al. Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children. Andrology. 2014;2(4):623–631.
  • 1. Willott GM. Frequency of azoospermia. Forensic Sci Int. 1982;20:9–10. 2. Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the azoospermic patient. J Urol. 1989;142:62–5. 3. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillens-jü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Rep-rod. 1998;13:1266–71. 4. Amer M, Ateyah A, Hany R, Zohdy W. Prospective compara-tive study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Rep-rod. 2000;15:653–6. 5. Tournaye H. Surgical sperm recovery for intracytoplasmic sperm injection: Which method is to be preferred? Hum Rep-rod. 1999;14:71–81. 6. Schlegel PN. Testicular sperm extraction: Microdissection improves sperm yield with minimal tissue excision. Hum Rep-rod. 1999;14:131–5. 7. Amer M, Ateyah A, Hany R, Zohdy W. Prospective compara-tive study between microsurgical and conventional testicular sperm extraction in non-obstructive azoospermia: Follow-up by serial ultrasound examinations. Hum Rep-rod. 2000;15:653–6. 8. Friedler S, Raziel A, Strassburger D, Soffer Y, Komarovsky D, Ron-El R. Testicular sperm retrieval by percutaneous fine needle sperm aspiration compared with testicular sperm extraction by open biopsy in men with non-obstructive azo-ospermia. Hum Reprod. 1997;12:1488–93. 9. Rosenlund B, Kvist U, Plüen L, Rozell BL, Sjüblom P, Hillens-jü T. A comparison between open and percutaneous needle biopsies in men with azoospermia. Hum Rep-rod. 1998;13:1266–71. 10. Tsujimura A, Miyagawa Y, Takao T, Takada S, Koga M, Takeyama M, et al. Salvage microdissection testicular sperm extraction after failed conventional testicular sperm extraction in patients with nonobstructive azoospermia. J Urol. 2006;175:1446–9. 11. Everaert K, De Croo I, Kerckhaert W, Dekuyper P, Dhont M, Van der Elst J, et al. Long term effects of micro-surgical testi-cular sperm extraction on androgen status in patients with non obstructive azoospermia. BMC Urol. 2006;6:9. 12. Moon MH, Kim SH, Cho JY, Seo JT, Chun YK. Scrotal US forevaluation of infertile men withazoosper-mia. Radiology. 2006;239:168–73. 13. Bryson CF, Ramasamy R, Sheehan M, Palermo GD, Ro-senwaks Z, et al. Severe testicularatrophydoes not af-fectthesuccess of microdissectiontesticular sperm extrac-tion. J Urol. 2014;191:175–8. 14. Zitzmann M, Nordhoff V, von Schonfeld V, Nordsiek-Mengede A, Kliesch S, Schuring AN, et al. Elevated follicle-stimulating hormone levels and the chances for azoospermic men to become fathers after retrieval of elongated sperma-tids from cryopreserved tes¬ticular tissue. FertilSteril. 2006; 86(2):339-347. 15. Hauser R, Temple-Smith PD, Southwick GJ, de Kretser D. Fertility in cases of hypergo¬nadotropic azoospermia. Fer-tilSteril. 1995; 63(3):631-636. 16. Ishikawa T. Surgicalrecovery of sperm in non-obstructiveazoospermia. Asian J Androl. 2012;14:109–15. 17. Jezek D, Knuth UA, Schulze W. Successfultesticular sperm extraction (TESE) in spite of high serum folliclestimulating-hormoneandazoospermia: correlationbetweentesticularmorp-hology, TESE results, semen analysisand serum hormoneva-lues in 103 infertile men. Hum Reprod. 1998;13:1230–4. 18. Ezeh UI, Taub NA, Moore HD, Cooke ID. Establishment of predictivevariablesassociatedwithtesticular sperm retrieval in men withnon-obstructiveazoospermia. Hum Rep-rod. 1999;14:1005–12. 19. Silber SJ, vanSteirteghem A, Nagy Z, Liu J, Tournaye H, et al. Normal pregnanciesresultingfromtesticular sperm extracti-onandintracytoplasmic sperm injectionforazoospermiadueto-maturationarrest. Fertil Steril. 1996;66:110–7. 20. Aksglaede L, Wikström AM, Rajpert-De Meyts E, Dunkel L, Skakkebaek NE, Juul A. Natural history of seminiferoustubu-ledegeneration in Klinefeltersyndrome. Hum Reprod Upda-te. 2006;12(1):39–48. 21. Foresta C, Galeazzi C, Bettella A, Marin P, Rossato M, Garol-la A, et al. Analysis of meiosis in intratesticulargermcellsfrom-subjectsaffectedbyclassicKlinefelter'ssyndrome. J ClinEndoc-rinolMetab. 1999;84(10):3807–3810. 22. Harari O, Bourne H, Baker G, Gronow M, Johnston I. High fertilization rate withintracytoplasmic sperm injection in mo-saicKlinefelter'ssyndrome. Fertil Steril. 1995;63(1):182–184. 23. Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. Sperm chromosomeanalysisandoutcome of IVF in pa-tientswithnon-mosaicKlinefelter'ssyndrome. Fertil Ste-ril. 2000;74(5):925–929. 24. Yarali H, Polat M, Bozdag G, Gunel M, Alpas I, Esinler I, et al. TESE-ICSI in patientswithnon-mosaicKlinefeltersyndrome: a comparativestudy. ReprodBiomed Online. 2009;18(6):756–760. 25. Madureira C, Cunha M, Sousa M, Neto A, Pinho M, Viana P, et al. Treatmentbytesticular sperm extractionandintracytop-lasmic sperm injection of 65 azoospermicpatientswithnon-mosaicKlinefeltersyndromewithbirth of 17 healthychild-ren. Andrology. 2014;2(4):623–631. 26. Reifsnyder JE, Ramasamy R, Husseini J, Schlegel PN. Role of optimizing testosterone before microdissection testicular sperm extraction in men with nonobstructive azoosper¬mia. The Journal of urology. 2012; 188(2):532-536. 27. Ramasamy R, Sterling J, Fisher ES, Li PS, Jain M, Robinson BD, et al. Identification of spermatogenesis with multiphoton microscopy: An evaluation in a rodent model. J Urol. 2011;186:2487–92. 28. Ramasamy R, Sterling J, Manzoor M, Salamoon B, Jain M, Fisher E, et al. Full field optical coherence tomography can identify spermatogenesis in a rodent sertoli-cell only model. J Pathol Inform. 2012;3:4.
There are 3 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Eyyup Sabri Pelit 0000-0001-8550-5072

Halil Çiftçi 0000-0002-4771-0232

Publication Date March 22, 2019
Submission Date October 30, 2018
Acceptance Date January 31, 2019
Published in Issue Year 2019 Volume: 16 Issue: 1

Cite

Vancouver Pelit ES, Çiftçi H. Non-obstrüktif Azospermik Hastalarda Mikrocerrahi Testiküler Sperm Ekstraksiyonu İlk Sonuçlarımız: Harran Üniversitesi Üroloji Kliniği. Harran Üniversitesi Tıp Fakültesi Dergisi. 2019;16(1):134-8.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty