Alpha Omega Alpha Honor Medical Society

2010 Research Abstract

Prediction of Success for Repeat Microdissection: Testicular Sperm Extraction (TESE) Procedures in Men with Non-Obstructive Azoospermia

Investigator: Joseph A. Ricci, B.A., Department of Urology, New York-Presbyterian Hospital-Weill Cornell Medical College
Mentor: Peter N. Schlegel, MD, Weill Cornell Medical College

The purpose of this study is to evaluate factors that predict successful repeat microdissection TESE in men with non-obstructive azoospermia. Few studies have evaluated which pre-operative factors predict an increased likelihood of success with the microdissection TESE procedure and no prior study has ever attempted to evaluate these factors for men hoping to undergo a repeat procedure. A retrospective analysis was carried out of men who underwent a repeat procedure after an initial successful attempt. Clinically-identifiable factors including hormonal levels (FSH, LH, Testosterone, and Estrogen) as well as testicular volume, histopathology on testes biopsy, operative time, presence of Klinefelter's syndrome and patient age were then compared between patients with successful and failed repeat outcomes. The results of the study demonstrated that mean FSH was lower and testicular volume was larger in patients with successful second attempts compared to men who failed. All other factors did not show a difference between the two groups and multivariate analysis did not identify factors that predict sperm retrieval. In conclusion, although men with lower FSH or larger testes may have a better chance of sperm retrieval, no factor predicts the success of repeat attempts. This study however, helps identify which patients are more likely to have a successful repeat operation, helping select those patients for surgery while alleviating the unnecessary pain and cost of surgery in patients for whom the procedure is likely to fail. Clearly though more studies are needed in this area to further elucidate which patients will be most likely to succeed and which will be most likely to fail the procedure.

Updated on January 6, 2011.

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