PMID- 17517404
OWN - NLM
STAT- MEDLINE
DCOM- 20080327
LR  - 20080311
IS  - 1556-5653 (Electronic)
IS  - 0015-0282 (Linking)
VI  - 89
IP  - 3
DP  - 2008 Mar
TI  - Single tubule biopsy: a new objective microsurgical advancement for testicular 
      sperm retrieval in patients with nonobstructive azoospermia.
PG  - 592-6
AB  - OBJECTIVE: The aim of this study was to measure the diameter of seminiferous 
      tubules (ST) during microdissection testicular sperm extraction (TESE) using a 
      micrometer fixed to one of the eyepieces of the operating microscope to find a 
      correlation between the extracted ST diameter and TESE outcome. DESIGN: A 
      prospective comparative study. SETTING: Adam International Andrology and 
      Infertility Clinic, Giza, Egypt. PATIENT(S): Two hundred sixty-four patients with 
      nonobstructive azoospermia (NOA) were included. INTERVENTION(S): Patients 
      underwent TESE using the open surgical technique. The STs were measured using the 
      micrometer, and the tubule with the largest diameter was excised and freshly 
      examined under an inverted microscope. If no spermatozoa were found, another 
      sample was taken from the second most dilated tubule area and then at random 
      until sperm were found or a maximum six samples were harvested. If no spermatozoa 
      were detected, the contralateral testis was operated upon. MAIN OUTCOME 
      MEASURE(S): The TESE outcome in relation to ST diameter. RESULT(S): The total 
      sperm recovery rate was 105 out of 264 (39.8%). When ST measured >or=300 microm 
      the sperm retrieval rate was 16 out of 19 (84.2%). When ST diameter was <300 
      microm, the sperm retrieval rate was 36.3% (89 out of 245). CONCLUSION(S): During 
      microdissection TESE, the best cutoff level of the ST diameter for harvesting 
      testicular spermatoza is 110 microm with sensitivity 86.0% and specificity 74.4% 
      (AUC 0.653, 95% confidence interval 0.608-0.663). When ST diameter is 300 microm 
      or more a single tubule biopsy is usually sufficient to harvest enough testicular 
      spermatozoa for intracytoplasmic sperm injection or sperm freezing with minimal 
      tissue excision.
FAU - Amer, Medhat
AU  - Amer M
AD  - Department of Andrology, Faculty of Medicine, Kaser El Aini, Cairo University 
      Hospital, Cairo, Egypt.
FAU - Zohdy, Wael
AU  - Zohdy W
FAU - Abd El Naser, Taha
AU  - Abd El Naser T
FAU - Hosny, Hossam
AU  - Hosny H
FAU - Arafa, Mohammed
AU  - Arafa M
FAU - Fakhry, Emad
AU  - Fakhry E
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
DEP - 20070522
PL  - United States
TA  - Fertil Steril
JT  - Fertility and sterility
JID - 0372772
SB  - IM
MH  - Adult
MH  - Azoospermia/pathology/*therapy
MH  - Biopsy/*methods
MH  - Cryopreservation
MH  - Humans
MH  - Male
MH  - *Microsurgery
MH  - Middle Aged
MH  - Prospective Studies
MH  - Semen Preservation
MH  - Seminiferous Tubules/pathology/*surgery
MH  - Sensitivity and Specificity
MH  - Sperm Injections, Intracytoplasmic
MH  - *Sperm Retrieval
MH  - Treatment Outcome
EDAT- 2007/05/23 09:00
MHDA- 2008/03/28 09:00
CRDT- 2007/05/23 09:00
PHST- 2006/10/05 00:00 [received]
PHST- 2007/03/12 00:00 [revised]
PHST- 2007/03/12 00:00 [accepted]
PHST- 2007/05/23 09:00 [pubmed]
PHST- 2008/03/28 09:00 [medline]
PHST- 2007/05/23 09:00 [entrez]
AID - S0015-0282(07)00661-9 [pii]
AID - 10.1016/j.fertnstert.2007.03.043 [doi]
PST - ppublish
SO  - Fertil Steril. 2008 Mar;89(3):592-6. doi: 10.1016/j.fertnstert.2007.03.043. Epub 
      2007 May 22.