Alahmari Abdullah, Akram Rabea, Maalouf Michael, Elsayed Abdulelah, Zini Armand
Division of Urology, Department of Surgery, McGill University, Montreal, QC H4A 3J1, Canada.
Department of Urology, King Faisal Specialist Hospital and Research Center, Jeddah, 23433, Saudi Arabia.
Can J Urol. 2025 Aug 29;32(4):317-323. doi: 10.32604/cju.2025.064517.
Testicular sperm aspiration (TESA) is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility. We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA).
This is a retrospective analysis of consecutive TESAs (primary and redo) for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center. We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit.
439 TESAs (366 primary and 73 redo) in men with severe OAT (n = 133) and OA (n = 306) were included. Men with OA had significantly higher sperm retrieval rate (SRR) and motile SRR compared to men with severe OAT (99% vs. 95% and 98% vs. 83%, respectively, p < 0.05). The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT (15% vs. 32% and 1.2 ± 0.5 vs. 1.4 ± 0.7, respectively, p < 0.05). In both groups, SRR, motile SRR, the requirement for multiple biopsies, and the total number of aspirates were not significantly different in primary compared to redo cases.
Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT. The data also demonstrate that a redo TESA in these men is as effective as a primary TESA, suggesting that areas of active spermatogenesis are preserved 6 months after TESA.
睾丸精子抽吸术（TESA）是一种微创睾丸精子获取技术，已被用于治疗男性因素不孕症。我们旨在评估严重少弱畸精子症（OAT）和梗阻性无精子症（OA）患者初次及再次TESA的精子获取结果。
这是一项对2011年1月至2022年8月在一家大型不孕症中心为严重OAT和OA患者进行的连续TESA（初次和再次）的回顾性分析。我们比较了严重OAT患者与OA患者的TESA结果，并比较了在同一睾丸单位接受初次和再次TESA的患者的结果。
纳入了严重OAT患者（n = 133）和OA患者（n = 306）的439次TESA（366次初次和73次再次）。与严重OAT患者相比，OA患者的精子获取率（SRR）和活动精子获取率显著更高（分别为99%对95%和98%对83%，p < 0.05）。与严重OAT患者相比，OA患者多次活检的需求和抽吸总数显著更低（分别为15%对32%和1.2±0.5对1.4±0.7，p < 0.05）。在两组中，初次与再次病例相比，SRR、活动SRR、多次活检的需求和抽吸总数均无显著差异。
我们的数据表明，与严重OAT患者相比，OA患者的TESA获取率显著更高。数据还表明，这些患者再次TESA与初次TESA一样有效，这表明TESA后6个月活跃精子发生区域得以保留。
