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KMID : 1037120190370010055
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The World Journal of Men′s Health
2019 Volume.37 No. 1 p.55 ~ p.67
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Testicular Fine-Needle Aspiration for Sperm Retrieval in Azoospermia: A Small Step toward the Technical Standardization
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Cito Gianmartin
Coccia Maria Elisabetta
Sessa Francesco
Cocci Andrea
Verrienti Pierangelo
Picone Rita
Fucci Rossella
Criscuoli Luciana
Serni Sergio
Carini Marco
Natali Alessandro
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Abstract
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Purpose: The aim was to describe our preliminary experience performing testicular fine-needle aspiration (TEFNA) with a larger needle in infertile patients with obstructive azoospermia, and to provide a systematic literature review of the different testicular sperm aspiration techniques, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations.
Materials and Methods: We prospectively collected data between March 2017 and June 2018. All men underwent bilateral TEFNA under analgo-sedation, using a larger disposable 18-gauge butterfly needle with 60 mL Luer-Lock syringe attached to it.
Results: Thirty consecutive patients were enrolled. Median operative time was 16 minutes (interquartile range [IQR]: 12?30 minutes). No intraoperative complications occurred. Two/thirty patients (6.7%) reported postoperative adverse events: 1 patient had prolonged orchialgia, 1 patient presented scrotal hematoma. Successful sperm retrieval was found in 28/30 cases (93.3%). Median sperm concentration was 0.05 ×106/mL (IQR: 0.001?0.1 ×106/mL). Median total sperm motility was 10% (IQR: 0%?15%). In 20/30 men (66.7%) sperm retrieved was used for fresh intracytoplasmic sperm injection cycle, in 8/30 (26.7%) sperm cryopreservation was necessary, because on the day of sperm retrieval the female resulted not responder to ovarian stimulation. In this cases mean number of 3 (IQR: 1?4) bio system straws was cryopreserved.
Conclusions: TEFNA with 18-gauge needle proved to be a feasible, safe and effective treatment, even if future prospective studies will be addressed to clarify what type of azoospermia benefits from this procedure, and if a larger needle permits to improve Assisted Reproductive Technologies (ART) outcomes.
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KEYWORD
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Azoospermia, Biopsy, fine-needle, Infertility, male, Reproductive techniques, Sperm retrieval
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