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Heterogenicity of testicular histopathology and tubules as a predictor of successful microdissection testicular sperm extraction in men with nonobstructive azoospermia.

Abstract Only a few studies evaluate the presence of spermatozoa intraoperatively. The study aimed to assess whether the heterogenicity of testicular histopathology and seminiferous tubules can predict the outcome of microdissection testicular sperm extraction (micro-TESE) in men with nonobstructive azoospermia (NOA).The study comprised a retrospective analysis of 94 patients with azoospermia who were referred from 2016 to 2017. Under optical magnification, they were classified into 2 groups based on the diameter of tubules intraoperatively, namely homogeneous tubules and heterogeneous tubules. Postoperatively, patients were divided into 2 groups of heterogeneous histopathology and homogeneous histopathology according to the 8 histopathological classification subgroups. The sperm retrieval rate was the main outcome.Testicular spermatozoa were successfully retrieved in 27 men (28%). The sperm retrieval rate in those with heterogeneous histopathology was higher than men with homogeneous histopathology (47% vs 12%; P < .001). The sperm retrieval rate of each histopathological subgroup in men who had the heterogeneous histopathology was higher, compared with the homogeneous histopathology (Sertoli cell only [SCO]: 30% vs 6%; maturation arrest [MA]: 38% vs 0%; tubular hyalinization: 42% vs 20%, respectively). Under the optical magnification, the sperm retrieval rate was significantly higher in men with heterogeneous vs homogeneous tubules (65% vs 15%, P < .001). Moreover, the sperm retrieval rate of the contralateral testicular was higher in men who had heterogeneous tubules, compared with the homogeneous tubules (25% vs 3%; P = .036).Heterogenicity of histopathology is an effective predictor in men with histopathological information available from a previous diagnostic biopsy or conventional TESE attempt preoperatively for successful sperm retrieval. Homogeneous tubules seem beneficial for some patients to perform a limited (superficial) contralateral micro-TESE after no spermatozoa were identified initially.
PMID
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Testicular histopathology as a predictor of a positive sperm retrieval in men with non-obstructive azoospermia.

Authors

Mayor MeshTerms

Azoospermia

Keywords
Journal Title medicine
Publication Year Start




PMID- 29851822
OWN - NLM
STAT- MEDLINE
DCOM- 20180611
LR  - 20180611
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 22
DP  - 2018 Jun
TI  - Heterogenicity of testicular histopathology and tubules as a predictor of
      successful microdissection testicular sperm extraction in men with nonobstructive
      azoospermia.
PG  - e10914
LID - 10.1097/MD.0000000000010914 [doi]
AB  - Only a few studies evaluate the presence of spermatozoa intraoperatively. The
      study aimed to assess whether the heterogenicity of testicular histopathology and
      seminiferous tubules can predict the outcome of microdissection testicular sperm 
      extraction (micro-TESE) in men with nonobstructive azoospermia (NOA).The study
      comprised a retrospective analysis of 94 patients with azoospermia who were
      referred from 2016 to 2017. Under optical magnification, they were classified
      into 2 groups based on the diameter of tubules intraoperatively, namely
      homogeneous tubules and heterogeneous tubules. Postoperatively, patients were
      divided into 2 groups of heterogeneous histopathology and homogeneous
      histopathology according to the 8 histopathological classification subgroups. The
      sperm retrieval rate was the main outcome.Testicular spermatozoa were
      successfully retrieved in 27 men (28%). The sperm retrieval rate in those with
      heterogeneous histopathology was higher than men with homogeneous histopathology 
      (47% vs 12%; P &lt; .001). The sperm retrieval rate of each histopathological
      subgroup in men who had the heterogeneous histopathology was higher, compared
      with the homogeneous histopathology (Sertoli cell only [SCO]: 30% vs 6%;
      maturation arrest [MA]: 38% vs 0%; tubular hyalinization: 42% vs 20%,
      respectively). Under the optical magnification, the sperm retrieval rate was
      significantly higher in men with heterogeneous vs homogeneous tubules (65% vs
      15%, P &lt; .001). Moreover, the sperm retrieval rate of the contralateral
      testicular was higher in men who had heterogeneous tubules, compared with the
      homogeneous tubules (25% vs 3%; P = .036).Heterogenicity of histopathology is an 
      effective predictor in men with histopathological information available from a
      previous diagnostic biopsy or conventional TESE attempt preoperatively for
      successful sperm retrieval. Homogeneous tubules seem beneficial for some patients
      to perform a limited (superficial) contralateral micro-TESE after no spermatozoa 
      were identified initially.
FAU - Yu, Yang
AU  - Yu Y
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
FAU - Xi, Qi
AU  - Xi Q
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
FAU - Wang, Ruixue
AU  - Wang R
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
FAU - Zhang, Hongguo
AU  - Zhang H
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
FAU - Li, Leilei
AU  - Li L
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
FAU - Liu, Ruizhi
AU  - Liu R
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
FAU - Pan, Yuan
AU  - Pan Y
AD  - Center for Reproductive Medicine and Center for Prenatal Diagnosis, First
      Hospital.
AD  - Jilin Engineering Research Center for Reproductive Medicine and Genetics, Jilin
      University, Changchun, China.
LA  - eng
PT  - Evaluation Studies
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - Azoospermia, Nonobstructive
SB  - AIM
SB  - IM
MH  - Adult
MH  - *Azoospermia
MH  - Humans
MH  - Male
MH  - Microdissection/*methods
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Seminiferous Tubules/*pathology/surgery
MH  - Sperm Retrieval/*statistics &amp; numerical data
MH  - Testis/*pathology/surgery
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2018/06/01 06:00
MHDA- 2018/06/12 06:00
CRDT- 2018/06/01 06:00
PHST- 2018/06/01 06:00 [entrez]
PHST- 2018/06/01 06:00 [pubmed]
PHST- 2018/06/12 06:00 [medline]
AID - 10.1097/MD.0000000000010914 [doi]
AID - 00005792-201806010-00050 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Jun;97(22):e10914. doi: 10.1097/MD.0000000000010914.