PMID- 23849579
OWN - NLM
STAT- MEDLINE
DCOM- 20140128
LR  - 20181023
IS  - 1677-6119 (Electronic)
IS  - 1677-5538 (Linking)
VI  - 39
IP  - 3
DP  - 2013 May-Jun
TI  - Microdissection testicular sperm extraction (micro-TESE) as a sperm acquisition 
      method for men with nonobstructive azoospermia seeking fertility: operative and 
      laboratory aspects.
PG  - 440; discussion 441
LID - 10.1590/S1677-5538.IBJU.2013.03.21 [doi]
AB  - INTRODUCTION: Rare foci of sperm production may be found in up to 60% of men with 
      nonobstructive azoospermia (NOA). Sperm production, if present, is minimal for 
      sperm appearance in the ejaculate. Given that there are no treatment options to 
      restore fertility, sperm retrieval is the only alternative to find testicular 
      sperm than then can be used for in vitro fertilization (IVF). Among sperm 
      acquisition methods, micro-TESE has higher success rates at obtaining sperm 
      compared with testicular sperm extraction and testicular sperm aspiration. 
      MATERIALS AND METHODS: This video describes the operative aspects of micro-TESE, 
      performed on an outpatient basis, in a man with NOA and history of cryptorchidism 
      in whom orchidopexy was performed at age 6. The concept of micro-TESE is to 
      identify areas of sperm production within the testes with the aid of optical 
      magnification (15-25X) and based on the size and appearance of the seminiferous 
      tubules (ST). RESULTS: Intraoperative findings revealed homogeneous pattern of 
      collapsed STs in which an area containing dilated STs was clearly identified and 
      extracted. Testicular tissue was then processed in the IVF laboratory to allow 
      sperm search. In this case, micro-TESE was successful at obtaining testicular 
      sperm for intracytoplasmic sperm injection (ICSI). Surplus retrieved testicular 
      spermatozoa not used for ICSI was cryopreserved. The operative time was 120 
      minutes, and intraoperative blood loss was negligible. Postoperatively, the 
      patient recovered to his normal activities within 5 days and no complications 
      were recorded except for minor testicular pain and scrotal swelling. CONCLUSION: 
      Micro-TESE allowed the identification and extraction of sperm-containing STs with 
      minimum tissue excision and marked reduction in time processing of testicular 
      specimens for sperm injection.
FAU - Esteves, Sandro C
AU  - Esteves SC
AD  - ANDROFERT, Center for Male Reproduction, Campinas, SP, Brazil. 
      s.esteves@androfert.com.br
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Video-Audio Media
PL  - Brazil
TA  - Int Braz J Urol
JT  - International braz j urol : official journal of the Brazilian Society of Urology
JID - 101158091
SB  - IM
MH  - *Azoospermia
MH  - Humans
MH  - Male
MH  - Microdissection/*methods
MH  - Reproducibility of Results
MH  - *Sperm Retrieval
MH  - Testis/*surgery
EDAT- 2013/07/16 06:00
MHDA- 2014/01/29 06:00
CRDT- 2013/07/16 06:00
PHST- 2013/01/10 00:00 [received]
PHST- 2013/02/27 00:00 [accepted]
PHST- 2013/07/16 06:00 [entrez]
PHST- 2013/07/16 06:00 [pubmed]
PHST- 2014/01/29 06:00 [medline]
AID - IBJUv39n3v2 [pii]
AID - 10.1590/S1677-5538.IBJU.2013.03.21 [doi]
PST - ppublish
SO  - Int Braz J Urol. 2013 May-Jun;39(3):440; discussion 441. doi: 
      10.1590/S1677-5538.IBJU.2013.03.21.