Utility of micro-TESE in the most severe cases of non-obstructive azoospermia.
Utility of micro-TESE in the most severe cases of non-obstructive azoospermia. Ups J Med Sci. 2020 Apr 01;:1-5 Authors: Westlander G Abstract The use of intracytoplasmic sperm injection (ICSI) has been a major breakthrough in the treatment of male infertility. Even patients with non-obstructive azoospermia (NOA) may benefit from the ICSI technique to father a child as long as spermatogenesis is present. There are several techniques to recover testicular sperm in patients with NOA. However, retrieval of spermatozoa is unfortunately still only successful in a subset of patients with NOA, and the most superior sperm retrieval method is still under debate. A more recent technique, microdissection testicular sperm extraction (MD-TESE) with an operative microscope collecting larger and more opaque seminiferous tubules, is a non-blind sperm retrieval technique with theoretical benefits. The MD-TESE procedure seems to be feasible, effective, and safe in NOA patients but also more technically demanding and time-consuming compared with conventional blind techniques. In the present report, we describe our clinical experience and results from our first 159 MD-TESE procedures. The probability to retrieve sperm with the MD-TESE technique is high in NOA cases where earlier sperm retrieval with blind methods such as needle aspiration, percutaneous needle biopsy, or conventional TESE has failed. PMID: 32233715 [PubMed - as supplied by publisher]
In every surgical field, paradigm shifts occur through innovation in either surgical approach or technology, and in the most dramatic instances through a combination of the two. For male reproductive surgery, a prime example is the advent of microdissection testicular sperm extraction (microTESE), in which technology (the operative microscope) facilitated a novel approach —high-magnification search for seminiferous tubules with distinct appearance—that dramatically changed the treatment paradigm for men with nonobstructive azoospermia.
Sperm identification during microdissection testicular sperm extraction (micro-TESE) for nonobstructive azoospermia (NOA) remains one of the greatest challenges in the surgical management of male factor infertility. The ability to successfully find sperm during micro-TESE is impacted by numerous factors: patient factors such as whether sperm is even present, laboratory processing techniques, person-hours spent searching for sperm, and the experience and expertise of the reproductive urology, embryology, and andrology team.
CONCLUSION: Scrotal MRI is a very effective tool for the evaluation of azoospermic men and may provide important information facilitating interventional treatment of infertility. PMID: 32441653 [PubMed - as supplied by publisher]
We report the following outcomes: (1) live birth rates in AID and IVF-D treatment for couples with severe male infertility factors and prior ICSI failures; (2) paternal impact on embryo development of the same oocyte cohort; (3) prognostic factors in obtaining a live birth with donor semen.ResultsOf 92 women with failed ICSI cycles (26 with multiple attempts), 45 couples underwent AID treatment. Live birth rate per cycle of AID was 18.9%. Fifty-three patients underwent IVF-D including 6 couples who previously did not conceive with AID. Embryological outcomes including fertilization, viable cleavage embryos, and blastocyst ...
ConclusionsThe finding in our patient and the discussion on the reviewed literature support a possible role forUSP26 in male fertility.
Genetic Testing and Molecular Biomarkers, Ahead of Print.
ConclusionsMiR ‐20a‐5p could represent a novel non‐invasive diagnostic biomarker of male infertility.
ConclusionThrough this study, we emphasize the necessity of a proper combination of high-throughput techniques with conventional cytogenetic and FISH methods. This could provide a personalized diagnostic and accurate results for the patients suffering from infertility or RPL. We also highlight FISH analyses, which are essential tools for detecting sSMC in infertile patients. In fact, despite its entire composition of heterochromatin, sSMC can have effects on spermatogenesis by producing mechanical perturbations during meiosis and increasing meiotic nondisjunction rate. This would contribute to understand the exact chromoso...
ConclusionGenetic testing (karyotyping and so on) played a key role in the diagnosis of our patient with long-term primary infertility secondary to 48,XXYY syndrome, and should play a vital role in all cases of long-term infertility, especially when presentation is accompanied by endocrine, skeletal, or morphological symptoms, signifying an underlying genetic factor.
This study aimed to determine the frequency and patterns of Y chromosome microdeletions in azoospermia factor (AZF) of Iraqi infertile males. Here, 90 azoospermic infertile males as a study group and 95 normal fertile males as control group were investigated for the microdeletion of AZF loci using numerous sequence-tagged sites. Of these 90 infertile male patients, 43 (47.8%) demonstrated Y chromosome microdeletions, in which AZFb region was the most deleted section inazoospermia patients (33.3%) followed by deletions in the AZFc region (23%), while there were no microdeletion in the AZFa region. The largest microdeletion ...