Correlation of histopathological findings in azoospermic males undergoing microsurgical testicular sperm extraction and sperm retrieval rate: a retrospective study

Authors

  • Devanshi Mishra Department of Reproductive Medicine, Bansal Hospital, Bhopal, M. P., India
  • Sameer Vyas
  • Rajshree Keshri

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20243936

Keywords:

Azoospermia, Histopathology, M-TESE, SSR rate

Abstract

Background: Male factor is the sole cause of infertility in 20% cases, and a contributory cause in 30-40% cases of infertility. Azoospermia is the absence of sperms in semen and it affects around 1% males. With the advent of procedures like testicular sperm aspiration (TESA) and microsurgical testicular sperm extraction (M-TESE), surgical sperm retrieval (SSR) has been made possible and such men can father their own genetic offspring with the help ofiIn vitro-fertilization-intra-cytoplasmic sperm injection (IVF-ICSI). Tissue can also be cryopreserved for use in future. Histopathological evaluation of testicular tissue obtained on diagnostic testicular biopsy/ M-TESE can help to predict the probability of finding sperms, the underlying etiology of azoospermia and also to establish obstructive (OA) cause when in doubt.

Methods: This is a retrospective analysis of database of 34 azoospermic males who underwent MTESE between year 2015- 2023 and for whom histopathology was done.

Results: In this study, SSR rate was 41.17%. The most common histopathological finding was Sertoli cell only syndrome in 41.1% cases (sperm retrieval rate 14.2%) followed by normal spermatogenesis in 17% cases (sperms found in 100% cases). Maturation arrest was found in 11.7% cases with sperms found in 25% cases. The study is limited by small sample size.

Conclusions: The histopathology of testicular tissue can provide valuable insights into predicting SSR rate and establishing diagnosis of OA etiology in azoospermia.

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Author Biographies

Sameer Vyas

Assistant professor, Department of Urology, Gandhi Medical College, Bhopal.

Rajshree Keshri

Senior Embryologist, Bansal Hospital, Bhopal

References

Donoso P, Tournaye H, Devroey P. Which is the best sperm retrieval technique for non-obstructive azoospermia? A systematic review. Hum Reprod Update. 2007;13(6):539-49.

Hamada AJ, Esteves SC, Agarwal A. A comprehensive review of genetics and genetic testing in azoospermia. Clinics (Sao Paulo). 2013;68(1):39-60.

Naru T, Sulaiman MN, Kidwai A, Ather MH, Waqar S, Virk S, et al. Intracytoplasmic sperm injection outcome using ejaculated sperm and retrieved sperm in azoospermic men. Urol J. 2008;5(2):106-10.

Tash JA, Schlegel PN. Histologic effects of testicular sperm extraction on the testicle in men with nonobstructive azoospermia. Urology. 2001;57(2):334-7.

Vicari E, Grazioso C, Burrello N, Cannizzaro M, D’Agata R, Calogero AE. Epididymal and testicular sperm retrieval in azoospermic patients and the outcome of intracytoplasmic sperm injection in relation to the etiology of azoospermia. Fertil Steril. 2001;75(1):215-6.

Esteves SC, Miyaoka R, Orosz JE, Agarwal A. An update on sperm retrieval techniques for azoospermic males. Clinics (Sao Paulo). 2013;68(1):99-110.

Gil-Salom M, Romero J, Rubio C, Ruiz A, Remohi J, Pellicer A. Intracytoplasmic sperm injection with cryopreserved testicular spermatozoa. Mol Cell Endocrinol. 2000;169(1-2):15-9.

Schroeder-Printzen I, Zumbe J, Bispink L, Palm S, Schneider U, Engelmann U, et al. Microsurgical epididymal sperm aspiration: aspirate analysis and straws available after cryopreservation in patients with non-reconstructable obstructive azoospermia. Hum Reprod. 2000;15(12):2531-5.

Schlegel PN. Causes of azoospermia and their management. Reprod Fertil Dev. 2004;16(5):561-72.

Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S, et al. Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod. 1997;12(1):80-6.

Manning M, Junemann KP, Alken P. Decrease in testosterone blood concentrations after testicular sperm extraction for intracytoplasmic sperm injection in azoospermic men. Lancet. 1998;352(9121):37.

Nistal M, Paniagua R. Testicular biopsy. Contemporary interpretation. Urol Clin North Am. 1999;26(3):555-93.

Infertility prevalence estimates, 1990-2021. Geneva: World Health Organization; 2023. Licence: CCBY-NC-SA 3.0 IGO. Available at: https://www.who.int. Accessed on 2 November 2024.

Siadati S, Shafi H, Ghorbani H. Testicular biopsy in males with infertility: A longitudinal study. Iran J Pathol. 2017;12(2):177-82.

Sayed MA, Mathur A, Joshi N, Juyal D, Thakur A. Histopathological patterns of the testicular biopsies and its role in the evaluation of infertility among azoospermic male patients: A hospital based study from northern India. Ann Int Med Dent Res. 2019;5(4):11-6.

Mushtaq H, Alam S, Khan MA. Histopathological pattern of testicular biopsies in male infertility. JIMDC. 2013;2(4):81-6.

Veeramachaneni LR. Role of Testicular Biopsy in male Infertility. J Clin Diagnostic Res. 2023;17(12):EC16-9.

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Published

2024-12-27

How to Cite

Mishra, D., Vyas, S., & Keshri, R. (2024). Correlation of histopathological findings in azoospermic males undergoing microsurgical testicular sperm extraction and sperm retrieval rate: a retrospective study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(1), 123–126. https://doi.org/10.18203/2320-1770.ijrcog20243936

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Original Research Articles