The Experts below are selected from a list of 2193 Experts worldwide ranked by ideXlab platform
Peter N Schlegel - One of the best experts on this subject based on the ideXlab platform.
-
anti mullerian hormone level as a predictor of Sperm Retrieval with microdissection testicular Sperm extraction in nonobstructive azooSpermia
Andrologia, 2021Co-Authors: Ahmad Aboukhshaba, Nahid Punjani, Sofia Doukakis, Peter N SchlegelAbstract:Limited factors effectively predict Sperm Retrieval with microdissection testicular Sperm extraction in men with nonobstructive azooSpermia. We therefore sought to evaluate the role of serum anti-Mullerian hormone as a predictive biomarker for successful Sperm Retrieval. We included patients with pre-operative anti-Mullerian hormone levels and stratified them based on prior history of prior Sperm Retrieval procedure. We compared hormone levels between those who did and did not have a successful Sperm Retrieval and used receiver operating curves to determine an optimal cut-off value. A total of 46 men were included, of whom 18 (39.1%) had no prior Sperm Retrieval and 11 (61.1%) had Sperm successfully retrieved. Pre-operative serum anti-Mullerian hormone levels were predictive of Sperm Retrieval in patients with no prior attempts at Retrieval (p = .03). Receiver operating curve for those without prior Retrieval was 0.6753. The optimal anti-Mullerian hormone cut-off for those without prior Sperm Retrieval was 0.133 ng/ml with a sensitivity of 0.91 and specificity of 0.29. Therefore, serum anti-Mullerian hormone levels have modest predictive value for Sperm Retrieval in this cohort. The combination of clinical history, examination and laboratory investigations should continue to be used to guide surgeons in counselling patients regarding the chance of Sperm Retrieval.
-
semen biomarker tex101 predicts Sperm Retrieval success for men with testicular failure
F1000Research, 2021Co-Authors: Peter N Schlegel, Keith Jarvi, Christina Schiza, Andrei P Drabovich, Susan Lau, Antoninus Soosaipillai, Dimitrios Korbakis, Davor BrincAbstract:Background: AzooSpermia could be due to either obstruction (obstructive azooSpermia: OA) or Spermatogenic failure (non-obstructive azooSpermia: NOA). Close to 50% of men with NOA have small pockets of Sperm in the testis which could be retrieved surgically and then injected into oocytes in a program of intra-cytoplasmic Sperm insertion. Presently, there are no accepted non-invasive tests allowing clinicians to predict the success rates of Sperm Retrieval. Previously, we have identified a germ cell-specific protein TEX101 in semen found in the primary Spermatocytes and more mature Sperm forms, but not in Spermatogonia, Sertoli or Leydig cells. We hypothesized that the semen concentration of TEX101 could be used to predict Sperm production in men with NOA. Methods: This was a prospective cohort study on men with NOA being treated at a male infertility centre. Men with NOA planning Sperm Retrieval provided 1–3 semen samples prior to surgery. Semen TEX101 concentrations were measured by an in-house-developed ELISA assay and compared with the results of the surgery to retrieve Sperm. Results: 20/60 karyotypically normal men with NOA had semen TEX101 LOD, Sperm was found in 50% (34-66%: 95% CI, sig diff. Fisher’s exact test, p<0.05). Conclusions: Undetectable (<0.2 ng/mL) semen TEX101 is highly predictive of Sperm Retrieval failure for karyotypically normal men with NOA and is the single strongest non-invasive predictor of Sperm Retrieval failure reported so far. Semen TEX101 concentration will help couples decide their individual chances of successful Sperm Retrieval.
-
histology and Sperm Retrieval among men with y chromosome microdeletions
Translational Andrology and Urology, 2021Co-Authors: Wallace Yuen, Andrew P Golin, Ryan Flannigan, Peter N SchlegelAbstract:In this review of Y chromosome microdeletions, azooSpermia factor (AZF) deletion subtypes, histological features and microTESE Sperm Retrieval rates are summarized after a systematic literature review. PubMed was searched and papers were identified using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Approximately half of infertile couples have a male factor contributing to their infertility. One of the most common genetic etiologies are Y chromosome microdeletions. Men with Y chromosome microdeletions may have rare Sperm available in the ejaculate or undergo surgical Sperm Retrieval and subsequent intracytoplasmic Sperm injection to produce offspring. AzooSpermia or severe oligozooSpermia are the most common semen analysis findings found in men with Y chromosome microdeletions, associated with impaired Spermatogenesis. Men with complete deletions of azooSpermia factor a, b, or a combination of any loci have severely impaired Spermatogenesis and are nearly always azooSpermic with no Sperm retrievable from the testis. Deletions of the azooSpermia factor c or d often have Sperm production and the highest likelihood of a successful Sperm Retrieval. In men with AZFc deletions, histologically, 46% of men demonstrate Sertoli cell only syndrome on biopsy, whereas 38.2% have maturation arrest and 15.7% have hypoSpermatogenesis. The microTESE Sperm Retrieval rates in AZFc-deleted men range from 13-100% based on the 32 studies analyzed, with a mean Sperm Retrieval rate of 47%.
-
age does not adversely affect Sperm Retrieval in men undergoing microdissection testicular Sperm extraction
Fertility and Sterility, 2014Co-Authors: Ranjith Ramasamy, Gianpiero D Palermo, Zev Rosenwaks, Jennifer Reifsnyder, Nikunj Trivedi, Peter N SchlegelAbstract:Objective To evaluate the effect of male age on the outcome of microdissection testicular Sperm extraction (micro-TESE) and assisted reproductive technology. Design Clinical retrospective study. Setting Center for reproductive medicine at a tertiary university hospital. Patient(s) One thousand sixty-seven men with nonobstructive azooSpermia. Intervention(s) Micro-TESE, with intracytoplasmic Sperm injection when Sperm found. Main Outcome Measure(s) Sperm Retrieval and clinical pregnancy. Result(s) Sperm were successfully retrieved by micro-TESE in 605 men (56.6%) overall. Sperm Retrieval rates (SRRs) were higher in men ≥50 years old than men Conclusion(s) Overall, SRRs in men undergoing micro-TESE are not negatively affected by age. Despite successful Sperm Retrieval in older men with micro-TESE, couples have the best chance of clinical pregnancy with a female partner
-
Sperm Retrieval and quality evaluation
Methods of Molecular Biology, 2014Co-Authors: Peter J Stahl, Peter N Schlegel, Marc GoldsteinAbstract:Technical refinements in Sperm Retrieval methods and the application of advanced reproductive technologies (ART) using surgically retrieved Sperm have enabled biological paternity in azooSpermic men who were considered untreatable 20 years ago. Achievement of optimal reproductive outcomes in these patients benefits greatly from a multistep, interdisciplinary process of Sperm acquisition that involves reproductive endocrinologists, urologists, or other specialists in male subfertility, and laboratory personnel with expertise in characterizing and isolating Sperm from surgically retrieved specimens. The critical steps in this process are discussed in this chapter.
Paul J Turek - One of the best experts on this subject based on the ideXlab platform.
-
Human Reproduction vol.13 no.5 pp.1260–1265, 1998 The mini-micro-epididymal Sperm aspiration for Sperm Retrieval: a study of urological outcomes
2015Co-Authors: David M Nudell, Joseph Conaghan, Roger A Pedersen, C R Givens, Eldon D Schriock, Paul J TurekAbstract:Epididymal Sperm aspiration and in-vitro fertilization (IVF) with intracytoplasmic Sperm injection is an estab-lished treatment for obstructive azooSpermia. Sperm aspiration is performed with either an incision or percutan-eously. To control costs, minimize morbidity and retain the advantages of both approaches, we developed a mini-incision technique for epididymal aspiration and here report Sperm Retrieval and procedure-related outcomes. Twenty-six consecutive patients with obstructive azoosper-mia underwent epididymal Sperm Retrieval through a 1 cm incision with local anaesthesia to provide Spermatozoa for concurrent IVF cycles. The quality of retrieved Spermato-zoa, the quantity of Spermatozoa cryopreserved as well as anaesthetic requirement, recovery time and patient satisfaction were evaluated. Fresh epididymal Spermatozoa were retrieved in 25 of 26 (96%) patients. In one patient, testicular Sperm extraction was necessary. Excess motile Spermatozoa were cryopreserved in 24 of 26 (92%) patients; a mean total motile count of 4.83106 motile Spermatozoa were banked. The procedure was performed with 62 % of patients receiving minimal i.v. sedation. Post-procedure recovery was rapid, with a median time to return to work of 2.0 days with a median of 2.0 pain pills taken. Procedure-related satisfaction was high. The mini-micro-epididymal Sperm aspiration achieves the goals of reliable Retrieval of abundant epididymal Spermatozoa with a single, minimally morbid procedure. It appears to combine the advantages of the incision and percutaneous approaches. Key words: MESA/Sperm cryopreservation/ICSI/microsurger
-
Sperm Retrieval techniques
Nature Reviews Urology, 2013Co-Authors: Daniel H Shin, Paul J TurekAbstract:Since the advent of intracytoplasmic Sperm injection in 1992, Sperm Retrieval procedures have been routinely employed to treat male infertility owing to azooSpermia. With obstructive azooSpermia, Sperm is potentially harvestable from the vas deferens, epididymis, and testicle using percutaneous and open Sperm Retrieval procedures that are relatively straightforward and reliable. In nonobstructive azooSpermia, Sperm is generally found only in the testicles and can often be difficult to retrieve. Several approaches aimed at maximizing Sperm yield in this condition have been developed, but only 50% of men with nonobstructive azooSpermia will have clinically usable Sperm. Multibiopsy testicular Sperm extraction (TESE), microdissection TESE, and fine-needle-aspiration map-guided TESE are three common methods currently employed to locate and retrieve Sperm in these difficult cases. Other factors that influence the use of surgically retrieved Sperm for assisted reproduction include differences in Sperm DNA integrity, the expertise of the surgeon and the andrology laboratory, and the described differences in the viability of Sperm from different anatomical sources after freezing and thawing.
-
posthumous Sperm Retrieval analysis of time interval to harvest Sperm
Human Reproduction, 2006Co-Authors: Paul J Turek, Shai Shefi, Gil Raviv, Michael L Eisenberg, R Weissenberg, L Jalalian, Jacob Levron, Gili Band, Igael MadgarAbstract:BACKGROUND: Current recommendations regarding posthumous Sperm Retrieval (PSR) are based on a small number of cases. Our purpose was to determine the time interval from death to a successful procedure. METHODS: Seventeen consecutive PSR procedures in 14 deceased and 3 neurologically brain-dead patients at two male infertility centres [Sheba Medical Center (SMC), Tel-Hashomer, Israel and University of California San Francisco (UCSF), San Francisco, CA, USA] were analysed. Main outcome measures were Retrieval of vital Sperm, pregnancies and births. RESULTS: PSR methods included resection of testis and epididymis (n = 8), en-block excision of testis, epididymis and proximal vas deferens with vasal irrigation (n = 6), electroejaculation (EEJ) (n = 2) and epididymectomy (n = 1). PSR was performed 7.5-36 h after death. Sperm was retrieved in all cases and was motile in 14 cases. In two cases, testicular and epididymal tissues were cryopreserved without Sperm evaluation, and in one case, no motility was detected. IVF and ICSI were performed in two cases in which Sperm had been retrieved 30 h after death, and both resulted in pregnancies and live births. CONCLUSIONS: Viable Sperm is obtainable with PSR well after the currently recommended 24-h time interval. PSR should be considered up to 36 h after death, following appropriate evaluation. No correlation was found between cause of death and chance for successful Sperm Retrieval.
-
the mini micro epididymal Sperm aspiration for Sperm Retrieval a study of urological outcomes
Human Reproduction, 1998Co-Authors: David M Nudell, Joseph Conaghan, Roger A Pedersen, C R Givens, Eldon D Schriock, Paul J TurekAbstract:Epididymal Sperm aspiration and in-vitro fertilization (IVF) with intracytoplasmic Sperm injection is an established treatment for obstructive azooSpermia. Sperm aspiration is performed with either an incision or percutaneously. To control costs, minimize morbidity and retain the advantages of both approaches, we developed a mini-incision technique for epididymal aspiration and here report Sperm Retrieval and procedure-related outcomes. Twenty-six consecutive patients with obstructive azooSpermia underwent epididymal Sperm Retrieval through a 1 cm incision with local anaesthesia to provide Spermatozoa for concurrent IVF cycles. The quality of retrieved Spermatozoa, the quantity of Spermatozoa cryopreserved as well as anaesthetic requirement, recovery time and patient satisfaction were evaluated. Fresh epididymal Spermatozoa were retrieved in 25 of 26 (96%) patients. In one patient, testicular Sperm extraction was necessary. Excess motile Spermatozoa were cryopreserved in 24 of 26 (92%) patients; a mean total motile count of 4.8x10(6) motile Spermatozoa were banked. The procedure was performed with 62% of patients receiving minimal i.v. sedation. Post-procedure recovery was rapid, with a median time to return to work of 2.0 days with a median of 2.0 pain pills taken. Procedure-related satisfaction was high. The mini-micro-epididymal Sperm aspiration achieves the goals of reliable Retrieval of abundant epididymal Spermatozoa with a single, minimally morbid procedure. It appears to combine the advantages of the incision and percutaneous approaches.
Ranjith Ramasamy - One of the best experts on this subject based on the ideXlab platform.
-
policy on posthumous Sperm Retrieval survey of 75 major academic medical centers
Urology, 2017Co-Authors: Nicholas Waler, Raul I Clavijo, Nancy L Brackett, Charles M Lynne, Ranjith RamasamyAbstract:Objective To evaluate the presence and content of policies on posthumous Sperm Retrieval at 75 major academic medical centers in the U.S. Materials and Methods We surveyed the top 75 major academic medical centers ranked for research in 2016 by U.S. News & World Report using a questionnaire-based telephone/web survey. We gathered data on the presence and content of posthumous Sperm Retrieval policies on the Internet. If not published, we contacted the legal counsel, the ethics and compliance offices, the urology department, as well as the infertility treatment center associated with each institution. In addition, we also surveyed members of the Society for Male Reproduction and Urology. Results We gathered data regarding posthumous Sperm Retrieval from 41 out of the 75 major academic medical centers. Of the 41 institutions, only 11 (26.8%) had policies regarding posthumous Sperm Retrieval. Out of those 11 centers, 4 required prior written consent, whereas the remaining 6 allowed for verbal or inferred consent from the surviving life partner. One policy prohibited the procedure. Five of the policies in this survey included a bereavement period. Of the 30 (73.2%) centers without policies, lack of legal guidance was cited as the most common barrier to policy adoption. Conclusion Only a small proportion of major academic medical centers have policies on posthumous Sperm Retrieval. Medical centers can adopt individualized policies based on guidelines published by professional societies.
-
age does not adversely affect Sperm Retrieval in men undergoing microdissection testicular Sperm extraction
Fertility and Sterility, 2014Co-Authors: Ranjith Ramasamy, Gianpiero D Palermo, Zev Rosenwaks, Jennifer Reifsnyder, Nikunj Trivedi, Peter N SchlegelAbstract:Objective To evaluate the effect of male age on the outcome of microdissection testicular Sperm extraction (micro-TESE) and assisted reproductive technology. Design Clinical retrospective study. Setting Center for reproductive medicine at a tertiary university hospital. Patient(s) One thousand sixty-seven men with nonobstructive azooSpermia. Intervention(s) Micro-TESE, with intracytoplasmic Sperm injection when Sperm found. Main Outcome Measure(s) Sperm Retrieval and clinical pregnancy. Result(s) Sperm were successfully retrieved by micro-TESE in 605 men (56.6%) overall. Sperm Retrieval rates (SRRs) were higher in men ≥50 years old than men Conclusion(s) Overall, SRRs in men undergoing micro-TESE are not negatively affected by age. Despite successful Sperm Retrieval in older men with micro-TESE, couples have the best chance of clinical pregnancy with a female partner
-
a comparison of models for predicting Sperm Retrieval before microdissection testicular Sperm extraction in men with nonobstructive azooSpermia
The Journal of Urology, 2013Co-Authors: Ranjith Ramasamy, Craig Niederberger, Jennifer Reifsnyder, Wendy O Padilla, Charles E Osterberg, Abhishek Kumar Srivastava, Peter N SchlegelAbstract:Purpose: We developed an artificial neural network and nomogram using readily available clinical features to model the chance of identifying Sperm with microdissection testicular Sperm extraction by readily available preoperative clinical parameters for men with nonobstructive azooSpermia.Materials and Methods: We reviewed the records of 1,026 men who underwent microdissection testicular Sperm extraction. Patient age, follicle-stimulating hormone level, testicular volume, history of cryptorchidism, Klinefelter syndrome and presence of varicocele were included in the models. For the artificial neural network the data set was divided randomly into a training set (75%) and a test set (25%) with n1/n2 cross validation used to evaluate model accuracy, and then modeled with a neural computational system. In addition, a nomogram with calibration plots was developed to predict Sperm Retrieval with microdissection testicular Sperm extraction. We compared these models to logistic regression.Results: The ROC area fo...
-
duration of microdissection testicular Sperm extraction procedures relationship to Sperm Retrieval success
The Journal of Urology, 2011Co-Authors: Ranjith Ramasamy, Joseph A Ricci, Robert Leung, Erik S Fisher, Peter N SchlegelAbstract:Purpose: We evaluated the operative time of microdissection testicular Sperm extraction in successful and failed procedures to identify the chance of Sperm Retrieval during longer microsurgical procedures.Materials and Methods: A total of 793 men with nonobstructive azooSpermia underwent a first attempt at microdissection testicular Sperm extraction from January 2000 to September 2009. Clinical factors were analyzed, including age, testicular volume, endocrinological data and histology. Operative time was calculated from incision until the procedure was terminated.Results: Testicular Sperm were successfully retrieved in 57% of the men. Sperm were found within 2, 2 to 4 and 4 to 7 hours in 89%, 30% and 37% of the men, respectively. There were no differences in preoperative clinical characteristics, age, follicle-stimulating hormone, testicular volume, incidence of a Klinefelter's syndrome diagnosis and distribution of most advanced histopathology in patients in the 3 operative time groups. In men in whom s...
-
microdissection testicular Sperm extraction effect of prior biopsy on success of Sperm Retrieval
The Journal of Urology, 2007Co-Authors: Ranjith Ramasamy, Peter N SchlegelAbstract:Purpose: We determined the effect of prior biopsies with no Sperm seen on the chance of Sperm Retrieval with microdissection testicular Sperm extraction in men with nonobstructive azooSpermia.Materials and Methods: A total of 311 men with NOA underwent microdissection testicular Sperm extraction. Of these patients 135 underwent no prior biopsies, 159 underwent 1 or 2 diagnostic testicular biopsies per testis and 17 underwent 3 or 4. The outcome measure studied was the success of Sperm Retrieval with microdissection testicular Sperm extraction. Serum follicle-stimulating hormone and histopathological diagnosis were examined as predictive factors for Sperm recovery.Results: Spermatozoa were retrieved in 150 men by microdissection testicular Sperm extraction (48%). The success of Sperm Retrieval in patients who underwent 3 to 4 biopsies (23%) was lower than the Retrieval rate in patients who underwent no prior biopsies (56%) and 1 to 2 biopsies per testis (51%) (p = 0.04). When histopathology was considered,...
Armand Zini - One of the best experts on this subject based on the ideXlab platform.
-
Sperm Retrieval and intracytoplasmic Sperm injection outcomes with testicular Sperm aspiration in men with severe oligozooSpermia and cryptozooSpermia
Cuaj-canadian Urological Association Journal, 2020Co-Authors: Mohannad Alharbi, Ahmad Almarzouq, Armand ZiniAbstract:INTRODUCTION Several studies addressed the role of testicular Sperm aspiration with intracytoplasmic Sperm injection (ICSI) in azooSpermic men but few have included non- azooSpermic men. The aim of this study was to evaluate testicular Sperm aspiration (TESA) Sperm Retrieval rates and ICSI outcomes in men with severe oligozooSpermia. METHODS Data were collected retrospectively from 88 consecutive, non-azooSpermic, infertile men with idiopathic severe oligozooSpermia who underwent TESA between January 2011 and January 2018. Patients were categorized into four groups according to Sperm concentration: 1 million/ml (group 1), 0.1 million/ml (group 2), <0.1 million/ml (group 3) and cryptozooSpermia (group 4). RESULTS Mean male age was 37±7 years and the mean female age was 33±4 years. Sperm was recovered successfully in 90% (79/88) of the men overall and in 100% (30/30) of the men in group 1, 97% (29/30) of the men in group 2, 88% (15/17) of the men in group 3, and 45% (5/11) of the men in group 4. Most (65%, 57/88) of the couples had an embryo transfer (ET). The overall clinical pregnancy rate per ET was 46% (26/57). The clinical pregnancy rates (per ET) were 43% (9/21) in group 1, 65% (13/20) in group 2, 36% (4/11) in group 3 and 0% (0/5) in group 4. CONCLUSIONS Our data indicate TESA allows for high Sperm Retrieval rates and acceptable ICSI pregnancy rates in men with severe oligozooSpermia. However, in our experience, TESA Sperm Retrieval rates and ICSI outcomes are poor in cryptozooSpermic men.
-
Sperm Retrieval outcomes with microdissection testicular Sperm extraction micro tese in men with cryptozooSpermia
Journal of Andrology, 2015Co-Authors: Khalid Alrabeeah, Simon J Phillips, A Wachter, B Cohen, Naif Alhathal, Armand ZiniAbstract:Summary Several studies support of the use of testicular rather than ejaculated Spermatozoa for intracytoplasmic Sperm injection (ICSI) in couples with virtual azooSpermia or cryptozooSpermia, although this approach remains controversial. We sought to evaluate Sperm Retrieval outcomes with microdissection testicular Sperm extraction (micro-TESE) in men with cryptozooSpermia. We conducted a retrospective study of 24 consecutive micro-TESEs in men with cryptozooSpermia. We also evaluated the outcomes of seven consecutive TESAs (testicular Sperm aspiration) in cryptozooSpermic men during the same time period (January 2007 and September 2014). Micro-TESE and TESA were performed on the day prior to ICSI. Final assessment of Sperm recovery (reported on the day of ICSI) was recorded as (i) successful (available Spermatozoa for ICSI) or (ii) unsuccessful (no Spermatozoa for ICSI). The decision to perform a unilateral or bilateral micro-TESE was guided by the intra-operative evaluation of Sperm recovery from the first testicle. A unilateral procedure was performed in 87.5% (21/24) and 57% (4/7) of the micro-TESE and TESA cohorts, respectively. Sperm recovery was successful in 96% (23/24) of the men who underwent micro-TESE and 43% (3/7) of the men who underwent TESA (p < 0.01). The ICSI pregnancy rates (per embryo transfer) in the micro-TESE and TESA groups were comparable [33% (6/18) and 50% (1/2), respectively]. The data indicate that micro-TESE is a highly successful Sperm Retrieval technique for men with cryptozooSpermia and few of these men will require a bilateral procedure. Moreover, Sperm Retrieval rates are higher with micro-TESE than TESA in this group of men.
-
Testicular Sperm aspiration for nonazooSpermic men: Sperm Retrieval and intracytoplasmic Sperm injection outcomes.
Urology, 2014Co-Authors: Khalid Alrabeeah, Simon J Phillips, Faysal A. Yafi, Christine Flageole, Audrey Wachter, François Bissonnette, Isaac Jacques Kadoch, Armand ZiniAbstract:Objective To evaluate testicular Sperm aspiration (TESA) Sperm Retrieval rates and intracytoplasmic Sperm injection outcomes in nonazooSpermic men. Materials and Methods Data were collected retrospectively from 54 consecutive, nonazooSpermic, infertile men who underwent TESA between March 2007 and September 2012. Sperm Retrieval rates and clinical pregnancy outcomes were recorded. Patients were subgrouped based on clinical diagnosis: group 1, anejaculation (primary, situational); group 2, idiopathic severe oligoasthenozooSpermia; and group 3, severe oligoasthenozooSpermia after vasovasostomy. Results Mean (±standard deviation) paternal and maternal ages were 39 ± 7 and 35 ± 5 years, respectively. Using TESA, Sperm recovery was successful in 94% (51 of 54) of the men overall and in 100% (17 of 17) of the men in group 1, 90% (28 of 31) in group 2, and 100% (6 of 6) in group 3. Overall, 35% of the couples achieved a clinical pregnancy using TESA Sperm (with a mean of 1.7 ± 0.9 embryos transferred per cycle). The clinical pregnancy rates were 40% in group 1, 33% in group 2, and 33% in group 3 with no significant difference in paternal or maternal age between groups. Conclusion The data indicate that TESA yields high Sperm Retrieval rates in select groups of nonazooSpermic infertile men, and this approach results in acceptable pregnancy rates regardless of the male infertility etiology. Randomized controlled trials comparing ejaculated vs testicular Sperm are needed to assess the true benefit of TESA-intracytoplasmic Sperm injection in these couples.
-
identification of Spermatozoa in archived testicular cancer specimens implications for bench side Sperm Retrieval at orchiectomy
Urology, 2010Co-Authors: Guila Delouya, Abdulaziz Baazeem, Jason Boman, Philippe D Violette, Fred Saad, Armand ZiniAbstract:OBJECTIVES To evaluate the patterns of Spermatogenesis in the normal testicular parenchyma of primary testicular cancers and estimate the feasibility of Sperm Retrieval at the time of radical orchiectomy. METHODS We reviewed the archived histologic sections of 39 consecutive patients who had undergone radical orchiectomy for primary testicular cancer at 3 university-affiliated hospitals. We examined all areas of normal (noncancerous) testicular parenchyma to evaluate the level of Spermatogenesis and presence of mature Spermatozoa in these sections. A minimum of 100 seminiferous tubules were scored per case. We also evaluated the epididymal tubules for the presence of mature Spermatozoa. A review of the clinical chart was performed to evaluate the relationship between clinical data and histologic findings. RESULTS In nearly 40% of the cases evaluated (15/38), the predominant histologic pattern was full Spermatogenesis. Mature Spermatozoa were identified in nearly 80% (30/38) of the testicular histologic sections and in 50% (14/28) of the evaluable epididymal sections. Clinical stage (presence of extranodal disease) and tumor marker levels were related to the probability of identifying mature Spermatozoa in the testis. CONCLUSIONS The data suggest that Sperm Retrieval at the time of radical orchiectomy is a feasible fertility option, with a 40% probability of recovering Spermatozoa by random biopsy of the noncancerous testicular parenchyma and an 80% probability of recovering Spermatozoa with a more extensive dissection. In 50% men, Spermatozoa may be recovered by epididymal aspiration alone.
David M Nudell - One of the best experts on this subject based on the ideXlab platform.
-
Human Reproduction vol.13 no.5 pp.1260–1265, 1998 The mini-micro-epididymal Sperm aspiration for Sperm Retrieval: a study of urological outcomes
2015Co-Authors: David M Nudell, Joseph Conaghan, Roger A Pedersen, C R Givens, Eldon D Schriock, Paul J TurekAbstract:Epididymal Sperm aspiration and in-vitro fertilization (IVF) with intracytoplasmic Sperm injection is an estab-lished treatment for obstructive azooSpermia. Sperm aspiration is performed with either an incision or percutan-eously. To control costs, minimize morbidity and retain the advantages of both approaches, we developed a mini-incision technique for epididymal aspiration and here report Sperm Retrieval and procedure-related outcomes. Twenty-six consecutive patients with obstructive azoosper-mia underwent epididymal Sperm Retrieval through a 1 cm incision with local anaesthesia to provide Spermatozoa for concurrent IVF cycles. The quality of retrieved Spermato-zoa, the quantity of Spermatozoa cryopreserved as well as anaesthetic requirement, recovery time and patient satisfaction were evaluated. Fresh epididymal Spermatozoa were retrieved in 25 of 26 (96%) patients. In one patient, testicular Sperm extraction was necessary. Excess motile Spermatozoa were cryopreserved in 24 of 26 (92%) patients; a mean total motile count of 4.83106 motile Spermatozoa were banked. The procedure was performed with 62 % of patients receiving minimal i.v. sedation. Post-procedure recovery was rapid, with a median time to return to work of 2.0 days with a median of 2.0 pain pills taken. Procedure-related satisfaction was high. The mini-micro-epididymal Sperm aspiration achieves the goals of reliable Retrieval of abundant epididymal Spermatozoa with a single, minimally morbid procedure. It appears to combine the advantages of the incision and percutaneous approaches. Key words: MESA/Sperm cryopreservation/ICSI/microsurger
-
the mini micro epididymal Sperm aspiration for Sperm Retrieval a study of urological outcomes
Human Reproduction, 1998Co-Authors: David M Nudell, Joseph Conaghan, Roger A Pedersen, C R Givens, Eldon D Schriock, Paul J TurekAbstract:Epididymal Sperm aspiration and in-vitro fertilization (IVF) with intracytoplasmic Sperm injection is an established treatment for obstructive azooSpermia. Sperm aspiration is performed with either an incision or percutaneously. To control costs, minimize morbidity and retain the advantages of both approaches, we developed a mini-incision technique for epididymal aspiration and here report Sperm Retrieval and procedure-related outcomes. Twenty-six consecutive patients with obstructive azooSpermia underwent epididymal Sperm Retrieval through a 1 cm incision with local anaesthesia to provide Spermatozoa for concurrent IVF cycles. The quality of retrieved Spermatozoa, the quantity of Spermatozoa cryopreserved as well as anaesthetic requirement, recovery time and patient satisfaction were evaluated. Fresh epididymal Spermatozoa were retrieved in 25 of 26 (96%) patients. In one patient, testicular Sperm extraction was necessary. Excess motile Spermatozoa were cryopreserved in 24 of 26 (92%) patients; a mean total motile count of 4.8x10(6) motile Spermatozoa were banked. The procedure was performed with 62% of patients receiving minimal i.v. sedation. Post-procedure recovery was rapid, with a median time to return to work of 2.0 days with a median of 2.0 pain pills taken. Procedure-related satisfaction was high. The mini-micro-epididymal Sperm aspiration achieves the goals of reliable Retrieval of abundant epididymal Spermatozoa with a single, minimally morbid procedure. It appears to combine the advantages of the incision and percutaneous approaches.