Mini-incision microdissection testicular sperm extraction: a useful technique for men with cryptozoospermia

Area of Science:

• Urology
• Reproductive Medicine
• Surgical Innovation

Background:

• Microdissection testicular sperm extraction (micro-TESE) is a surgical technique for sperm retrieval in infertile men.
• Minimizing testicular injury is a key goal in sperm extraction procedures.
• Non-obstructive azoospermia (NOA) and cryptozoospermia present challenges for sperm retrieval.

Purpose of the Study:

• To evaluate the efficacy of a mini-incision micro-TESE technique.
• To assess sperm recovery rates in men with cryptozoospermia and NOA undergoing micro-TESE.
• To compare outcomes of mini-incision versus standard micro-TESE based on intra-operative findings.

Main Methods:

• Retrospective study of 26 consecutive men with NOA or cryptozoospermia undergoing primary micro-TESE.
• Sperm recovery assessed intra-operatively to guide decision between mini-incision and standard/extensive micro-TESE.
• Sperm recovery success defined by availability of spermatozoa for intracytoplasmic sperm injection (ICSI).

Main Results:

• Overall sperm recovery success rate was 77% (20/26).
• Mini-incision micro-TESE was successful in 37% (8/26) of cases.
• Sperm recovery was successful in 60% of men with cryptozoospermia and 13% with NOA using the mini-incision approach.

Conclusions:

• A mini-incision micro-TESE, combined with rapid intra-operative assessment, can be effective for sperm retrieval.
• This technique appears particularly beneficial for men with cryptozoospermia.
• The findings support the utility of a tailored micro-TESE approach based on intra-operative sperm identification.