Health Sciences University, Gaziosmanpaşa Education and Research Hospital, Urology Clinic, Istanbul, Turkey.
SENSART, Obstetrics and Gynecology, Istanbul, Turkey.
Fertil Steril. 2021 Apr;115(4):915-921. doi: 10.1016/j.fertnstert.2020.10.005. Epub 2020 Dec 23.
To evaluate the efficacy of the second micro-testicular sperm extraction (TESE)in men with nonobstructive azoospermia in whom the first micro-TESE failed.
Retrospective.
Private clinic.
PATIENT(S): One hundred twenty-five men with nonobstructive azoospermia with failed previous micro-TESE. The patients were divided into 2 groups according to their surgical sperm retrieval status during the second micro-TESE. If sperm could not be found, these patients were classified as Group 1, and, if sperm was found, the patients were classified as Group 2. The 2 groups were compared for clinical parameters and pathologic findings.
INTERVENTION(S): Micro-TESE.
MAIN OUTCOME MEASURE(S): Surgical sperm retrieval status.
RESULT(S): Sperm was recovered successfully in 23 of 125 (18.4%) men with the second micro-TESE. Testicular volume was significantly lower in Group 2 (8.2 ± 5.4 mL) than Group 1 (11.3 ± 5.3 mL). Seven of 14 (50%) patients with Klinefelter's Syndrome had sperm recovery with repeat micro-TESE. The sperm retrieval rate was significantly higher in the Leydig cell hyperplasia and tubular sclerosis groups than in the Sertoli cell only and maturation arrest groups (54.5%, 10.1%, and 18.6%, respectively).
CONCLUSION(S): On the basis of our results, 18.4% of men with failed first micro-TESE had a probability of sperm retrieval with the second micro-TESE. Patients with successful sperm recovery had smaller testicular volumes than those with a failed second attempt. Severe testicular atrophy was not a contraindication for the second micro-TESE in such patients.
评估首次微睾丸精子提取（TESE）失败的非梗阻性无精子症男性进行第二次微 TESE 的疗效。
回顾性。
私人诊所。
125 名非梗阻性无精子症且首次微 TESE 失败的男性患者。根据第二次微 TESE 期间的手术精子获取情况，将患者分为 2 组。如果未发现精子，则将这些患者分类为第 1 组，如果发现精子，则将患者分类为第 2 组。比较两组的临床参数和病理发现。
微 TESE。
手术精子获取情况。
第二次微 TESE 成功恢复精子的男性有 23 名（18.4%）。第 2 组的睾丸体积明显小于第 1 组（8.2±5.4ml 比 11.3±5.3ml）。14 名克氏综合征患者中有 7 名（50%）通过重复微 TESE 获得精子。在间质细胞瘤增生和小管硬化组中，精子获取率明显高于仅支持细胞和成熟阻滞组（分别为 54.5%、10.1%和 18.6%）。
根据我们的结果，首次微 TESE 失败的男性中有 18.4%的人有第二次微 TESE 获得精子的可能性。成功恢复精子的患者睾丸体积小于第二次尝试失败的患者。对于此类患者，严重的睾丸萎缩并不是进行第二次微 TESE 的禁忌症。
