Sperm retrieval rate: comparative single surgeon results between first 30 consecutive c-TESE and first 30 m-TESE in NOA patients
Sacca, A1; La Croce, G1; Manica, M1; Nicolai, M1; Belussi, D1; Rocchini, L1; Pellucchi, F1; Deiana, G1; Castellucci, E1; Naspro, RL1; Roscigno, M1; Angiolilli, D1; Da Pozzo, LF1
1: ASST PAPA GIOVANNI XXIII, BERGAMO, Italy
Objectives: In the current literature, controversy is still present if m-TESE has to be considered the gold standard technique to retrieve sperms in non obstructive azoospermia (NOA) patients.
In this study we reported comparative results regarding to testicular sperm retrieval in NOA patients, submitted to m-TESE and c-TESE in a non academic centre.
Material and Methods: Complete data of 60 consecutive Caucasian males, suffering from primary infertility, were collected between January 2015 and October 2017. All patients were referred to our center for TESE, conventional (c-TESE) or microscopic (m-TESE); we started performing m-TESE in September 2016. All procedures were performed by the same surgeon (AS). Statistical analysis were conducted in order to evaluate correlations between first 30 c-TESE and first 30 m-TESE in terms of demographic data, cause of infertility, time to first infertility diagnosis, serum levels of hormones, operative results, sperm retrieval rate and histological findings. Chi-square and ANOVA test were used to examine the differences in categorical and continuous variables, respectively.
Results: Groups were comparable in terms of clinical characteristics. Any difference was found in terms of age (p=0.1), time to first infertility diagnosis (p=0.3), serum hormone levels (FSH , LH, prolactin and total testosterone) (all p > 0.05), genetic clinical profiles (p=0.2). Moreover no statistically significant difference was found in terms of surgical time (P=0.07). Positive sperm retrieval rate (p-SRR) was slightly superior in m-TESE pts than c-TESE (72% vs70%), but not statistically significant. Consensual testicular biopsy was performed in all pts: no differences were found between groups in terms of severe hypospermatogenesis with maturation arrest, Sertoli Cell Only Syndrome and testicular atrophy (all p> 0.05).
Conclusions: Conventional TESE still remains a valuable approach for sperm retrieval in NOA patients, in comparison with m-TESE. In our experience, surgical time does not represent a critical variable in choosing type of procedure. Again, cost is still the only enemy of the m-TESE.
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