Role of Repeated Sperm Extraction by Enzymatic and Mechanical Mincing Techniques in Azoospemic Patients

Amina Al-Tameemi; Ali Ibrahim Rahim; Ula Al-Kawaz

doi:10.28969/IJEIR.v13.i1.r7.23

Authors

Amina Al-Tameemi Institute for infertility diagnosis and reproductive technologies
Ali Ibrahim Rahim College of Medicine, University of Kufa, Najaf, Iraq
Ula Al-Kawaz High Institute for Infertility Diagnosis and Assisted Reproductive Technology, Al-Nahrain University. Baghdad, Iraq,

DOI:

https://doi.org/10.28969/IJEIR.v13.i1.r7.23

Keywords:

TESE, mechanicanical, enzymatic

Abstract

Azoospermic patients have the option of undergoing in vitro fertilization
procedures, specifically intracytoplasmic sperm injection (ICSI), for which
sperm is retrieved from the patient's own testicles and then injected directly
into the oocyte. The aim of the study: evaluate the role of repeated sperm
extraction by enzymatic and mechanical mincing techniques in azoospemic
patients. A total of 32 males with non-obstructive azoospermia participated in
the research. Testicular sperm extraction (TESE) was performed under spinal
or general anesthesia after a comprehensive history, physical examination,
and investigations. After that, the biopsies underwent through a series of
mincing processes, both mechanical and enzymatic. Patients gave information
including age, body mass index and previous biopsy attempts. In both
enzymatic and mechanical methods there was no significant higher sperm
recovery in patients with history of previous testicular biopsies (66.7% vs.
38.5%; p=0.209) and (66.7% vs. 30.8%; p=0.102) respectively. Patients who
had undergone prior testicular biopsies had marginally higher sperm recovery
rates using both enzymatic and mechanical techniques

Downloads

Article Views | PDF Downloads

Range Graph | Chart Graph

References

Durairajanayagam D. Lifestyle causes of male infertility. Arab J Urol. 2018 Mar 1;16(1):10–20.

Dissanayake DMIH, Keerthirathna WLR, Peiris LDC. Male Infertility Problem: A Contemporary Review on Present Status and Future Perspective. Gend Genome. 2019 Jan;3:247028971986824.

MALE INFERTILITY A CHILD OF OUR OWN A BOOKLET IN THE SERIES OF CONSUMER GUIDES ON MALE REPRODUCTIVE HEALTH FROM. 2004.

Jarow JP, Espeland MA, Lipshultz LI. Evaluation of the Azoospermic Patient. J Urol. 1989 Jul 1;142(1):62–5.

Caroppo E, Colpi EM, Gazzano G, Vaccalluzzo L, Scroppo FI, D’Amato G, et al. Testicular histology may predict the successful sperm retrieval in patients with non-obstructive azoospermia undergoing conventional TESE: a diagnostic accuracy study. J Assist Reprod Genet. 2017 Jan 1;34(1):149–54.

Oldereid NB, Hanevik HI, Bakkevig I, Romundstad LB, Magnus O, Hazekamp J, et al. Pregnancy outcome according to male diagnosis after ICSI with non-ejaculated sperm compared with ejaculated sperm controls. Reprod Biomed Online. 2014 Oct 1;29(4):417–23.

Jungwirth A, Giwercman A, Tournaye H, Diemer T, Kopa Z, Dohle G, et al. European association of urology guidelines on male infertility: The 2012 update. Eur Urol. 2012;62(2):324–32.

Modarresi T, Sabbaghian M, Shahverdi A, Hosseinifar H, Asghar Akhlaghi A, Ali Sadighi Gilani M. Enzymatic digestion improves testicular sperm retrieval in non-obstructive azoospermic patients. Vol. 11, Iran J Reprod Med. 2013.

WHO laboratory manual for the examination and processing of human semen Sixth Edition.

Dabaja AA, Schlegel PN. Microdissection testicular sperm extraction: An update. Vol. 15, Asian Journal of Andrology. 2013. p. 35–9.

Vernaeve V, Verheyen G, Goossens A, Van Steirteghem A, Devroey P, Tournaye H. How successful is repeat testicular sperm extraction in patients with azoospermia? Human Reproduction [Internet]. 2006 Jun 1 [cited 2023 Jul 28];21(6):1551–4. Available from: https://dx.doi.org/10.1093/humrep/del012

Kalsi J, Thum MY, Muneer A, Abdullah H, Minhas S. In the era of micro-dissection sperm retrieval (m-TESE) is an isolated testicular biopsy necessary in the management of men with non-obstructive azoospermia? BJU Int [Internet]. 2012 Feb 1 [cited 2023 Jul 28];109(3):418–24. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2011.10399.x

Herwig R, Tosun K, Pinggera GM, Soelder E, Moeller KT, Pallwein L, et al. Tissue perfusion essential for spermatogenesis and outcome of testicular sperm extraction (TESE) for assisted reproduction. J Assist Reprod Genet [Internet]. 2004 May [cited 2023 Jul 28];21(5):175–80. Available from: https://link.springer.com/article/10.1023/B:JARG.0000031251.57848.04

Tsujimura A, Miyagawa Y, Takao T, Takada S, Koga M, Takeyama M, et al. Salvage Microdissection Testicular Sperm Extraction After Failed Conventional Testicular Sperm Extraction in Patients With Nonobstructive Azoospermia. J Urol. 2006 Apr 1;175(4):1446–9.