Age does not adversely affect sperm retrieval in men undergoing microdissection testicular sperm extraction

Capsule:
Sperm retrieval in men undergoing microdissection testicular sperm extraction (micro-TESE) was not negatively affected by age. Men 50 years old who underwent successful micro-TESE were more likely to have larger testes.

Authors:
Ranjith Ramasamy, M.D., Nikunj N. Trivedi, B.S., Jennifer E. Reifsnyder, M.D., Gianpiero D. Palermo, M.D., Ph.D., Zev Rosenwaks, M.D., Peter N. Schlegel, M.D.

Volume 101, Issue 3, Pages 653-655, March 2014

Abstract:

Objective:
To evaluate the effect of male age on the outcome of microdissection testicular sperm extraction (micro-TESE) and assisted reproductive technology.

Design:
Clinical retrospective study.

Setting:
Center for reproductive medicine at a tertiary university hospital.

Patient(s):
One thousand sixty-seven men with nonobstructive azoospermia.

Intervention(s):
Micro-TESE, with intracytoplasmic sperm injection when sperm found.

Main Outcome Measure(s):
Sperm retrieval and clinical pregnancy.

Result(s):
Sperm were successfully retrieved by micro-TESE in 605 men (56.6%) overall. Sperm retrieval rates (SRRs) were higher in men ≥50 years old than men <50, (73% in men ≥50, 56% in men <50). Of the 44 men ≥50 years old, men who had successful micro-TESE had larger mean testis volume (20.8 cc vs. 12.5 cc), a higher frequency of hypospermatogenesis (5.6% vs. 0%), and a lower frequency of Sertoli cells only (12.5% vs. 80%) on diagnostic biopsy. Clinical pregnancy rates were lower in partners of men ≥50 than in partners of men

Conclusion(s):
Overall, SRRs in men undergoing micro-TESE are not negatively affected by age. Despite successful sperm retrieval in older men with micro-TESE, couples have the best chance of clinical pregnancy with a female partner

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