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  • Title: Efficacy of the second micro-testicular sperm extraction after failed first micro-testicular sperm extraction in men with nonobstructive azoospermia.
    Author: Özman O, Tosun S, Bayazıt N, Cengiz S, Bakırcıoğlu ME.
    Journal: Fertil Steril; 2021 Apr; 115(4):915-921. PubMed ID: 33358250.
    Abstract:
    OBJECTIVE: To evaluate the efficacy of the second micro-testicular sperm extraction (TESE)in men with nonobstructive azoospermia in whom the first micro-TESE failed. DESIGN: Retrospective. SETTING: Private clinic. PATIENT(S): One hundred twenty-five men with nonobstructive azoospermia with failed previous micro-TESE. The patients were divided into 2 groups according to their surgical sperm retrieval status during the second micro-TESE. If sperm could not be found, these patients were classified as Group 1, and, if sperm was found, the patients were classified as Group 2. The 2 groups were compared for clinical parameters and pathologic findings. INTERVENTION(S): Micro-TESE. MAIN OUTCOME MEASURE(S): Surgical sperm retrieval status. RESULT(S): Sperm was recovered successfully in 23 of 125 (18.4%) men with the second micro-TESE. Testicular volume was significantly lower in Group 2 (8.2 ± 5.4 mL) than Group 1 (11.3 ± 5.3 mL). Seven of 14 (50%) patients with Klinefelter's Syndrome had sperm recovery with repeat micro-TESE. The sperm retrieval rate was significantly higher in the Leydig cell hyperplasia and tubular sclerosis groups than in the Sertoli cell only and maturation arrest groups (54.5%, 10.1%, and 18.6%, respectively). CONCLUSION(S): On the basis of our results, 18.4% of men with failed first micro-TESE had a probability of sperm retrieval with the second micro-TESE. Patients with successful sperm recovery had smaller testicular volumes than those with a failed second attempt. Severe testicular atrophy was not a contraindication for the second micro-TESE in such patients.
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