Related Experiment Video
Updated: Jul 11, 2026
06:28
Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
Fine needle aspiration vs. mTESE in non-obstructive azoospermia
S El-Haggar1, T Mostafa, T Abdel Nasser
1Department of Andrology and Sexology, Faculty of Medicine, Cairo University, Cairo, Egypt.
International Journal of Andrology
|September 8, 2007
Summary
Microdissection testicular sperm extraction (mTESE) is superior to fine needle aspiration (FNA) for sperm retrieval in non-obstructive azoospermia (NOA). mTESE offers significantly higher success rates and fewer complications compared to FNA.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Non-obstructive azoospermia (NOA) affects a significant portion of infertile men.
- Accurate sperm retrieval techniques are crucial for assisted reproductive technologies in NOA patients.
- Comparing surgical sperm extraction methods is essential for optimizing patient outcomes.
Purpose of the Study:
- To compare the efficacy and complication rates of fine needle aspiration (FNA) versus microdissection testicular sperm extraction (mTESE) for sperm retrieval in patients with NOA.
- To evaluate the overall sperm retrieval rate (SRR) for both FNA and mTESE.
- To assess the incidence of early and long-term complications associated with each procedure.
Main Methods:
- Prospective study involving 100 patients diagnosed with non-obstructive azoospermia (NOA).
- Patients underwent standard diagnostic workup including history, physical examination, semen analysis, FSH levels, and scrotal Doppler ultrasound.
- One testis was subjected to FNA for sperm screening, while the contralateral testis underwent mTESE and subsequent histopathology. Follow-up included ultrasonography at 1, 3, and 6 months.
Main Results:
- The overall sperm retrieval rate was significantly higher with mTESE (54%) compared to FNA (10%).
- mTESE successfully retrieved sperm across various testicular pathologies including hypospermatogenesis, severe hypospermatogenesis, Sertoli cell only (SCO) syndrome, germ cell arrest, and tubular hyalinization.
- FNA demonstrated lower retrieval rates across all pathologies and retrieved no sperm in cases of tubular hyalinization. Complication rates were 10% early for mTESE versus 24% for FNA, with no long-term complications reported for mTESE.
Conclusions:
- Microdissection testicular sperm extraction (mTESE) is a superior technique for sperm retrieval in non-obstructive azoospermia (NOA) patients due to its significantly higher success rate.
- mTESE is associated with a lower incidence of complications compared to fine needle aspiration (FNA).
- The findings support the use of mTESE as the preferred method for sperm retrieval in NOA, offering better outcomes for infertile men.
