Does testicular sperm retrieval adversely impact spermatogenesis over the long-term?

Andrologia. 2022 Jul;54(6):e14401. doi: 10.1111/and.14401. Epub 2022 Mar 3.

Abstract

Testicular sperm retrieval (TSR) techniques are valuable in the context of severe idiopathic male factor infertility; however, there are few studies in the literature examining the long-term impact of TSR on testicular function. The objective was to determine whether testicular sperm aspiration (TESA) or microdissection testicular sperm extraction (micro-TESE) worsens the pre-existing spermatogenesis deficiency in men with either cryptozoospermia or severe oligozoospermia. The study population consisted of 145 men with either cryptozoospermia or severe oligozoospermia that underwent TESA or micro-TESE and had long-term post-operative semen analyses (SA). Patients with SA prior to and following TSR were included (n = 24). Amongst them, 16 men underwent TESA and 8 underwent micro-TESE. The follow-up SA was obtained at a mean of 3.0 ± 2.0 years following TSR (range: 0.3-8.3 years) amongst all participants. The post-operative semen parameters in the TESA group were similar to the pre-intervention parameters (p > 0.1). Similarly, the micro-TESE cohort did not demonstrate significant alterations in semen parameters post-intervention (p > 0.05). None of the men in the study became azoospermic following the TSR. Our study indicates TESA or micro-TESE do not appear to worsen the pre-existing spermatogenesis deficiencies in cryptozoospermic and oligozoospermic men over a long-term period. Larger studies are required to corroborate these findings.

Keywords: TESA; male infertility; micro-TESE; sperm retrieval; spermatogenesis.

MeSH terms

  • Azoospermia* / etiology
  • Azoospermia* / surgery
  • Humans
  • Infertility, Male*
  • Male
  • Microdissection / methods
  • Oligospermia* / etiology
  • Retrospective Studies
  • Sperm Retrieval
  • Spermatogenesis
  • Testis / surgery