[Results of surgical testicular sperm extractions (TESE) in a population of azoospermic patients with a history of cryptorchidism based on a 10-year experience of 142 patients].

INTRODUCTION

Cryptorchidism is a common and possible etiology of male infertility.

OBJECTIVES

This is a retrospective study of 142 azoospermic men with history of cryptorchidism. A testicular sperm extraction (TESE) was performed for each of them, between 1995 and 2005, to realize in vitro fecundation with intracytoplasmic sperm injection (ICSI).

MATERIAL AND METHODS

We studied the clinical pattern (age at the treatment, unilateral or bilateral cryptorchidism), hormonal levels (total testosterone and FSH) and ultrasound examinations in this population. Then, we studied the rates of successful TESE according to these various characteristics.

RESULTS

The main origin of azoospermia is non obstructive (secretory). A great majority of the patients (71.8%) has benefited of an orchidopexy before the age of 10 years which does not seem to represent a factor of better forecast of surgical extraction of sperm cells. In the subgroup of the bilateral cryptorchidy, the rate of extraction was 63% (55/87). In the subgroup of the one-sided cryptorchidy, it was 61.9% (36/42).

CONCLUSION

For us, history of cryptorchidism is an etiology of good prognosis for azoospermia, since the rate of TESE with positive sperm retrieval is 65%. In our population, the subgroups of patients whose FSH is normal and/or whose testicular volume is higher than 10 cm3 are those whose forecast is still better, because the rate of TESE with positive sperm retrieval is 75%.