Microsurgical testicular sperm extraction for testicular failure: the South African experience and first successful pregnancy

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dc.contributor.authorZarrabi, A. D.en_ZA
dc.contributor.authorKruger, T. F.en_ZA
dc.date.accessioned2022-03-30T10:43:01Z
dc.date.available2022-03-30T10:43:01Z
dc.date.issued2021-06
dc.descriptionCITATION: Zarrabi, A. D. & Kruger, T. F. 202). Microsurgical testicular sperm extraction for testicular failure : the South African experience and first successful pregnancy. South African Journal of Surgery, 59(2):52-56, doi:10.17159/2078-5151/2021/v59n2a3230.en_ZA
dc.descriptionThe original publication is available at: http://www.scielo.org.za
dc.description.abstractBACKGROUND: In men with non-obstructive azoospermia (NOA), biological fatherhood is only possibly by specialised microsurgical sperm retrieval techniques (micro-TESE), only recently introduced to South Africa. This study aimed to analyse the spectrum of causes of NOA and the outcomes of micro-TESE, including live births, following the use of this technique in South Africa METHODS: This was a retrospective review of all micro-TESE cases performed in South Africa by a single surgeon from 2014 to 2018. Data collected prospectively included: patient demographics, preoperative blood results, cause of azoospermia, intraoperative findings and postoperative complications. The primary outcome measured was surgical success of micro-TESE, which was defined as testicular sperm successfully retrieved and cryopreserved. Subsequent live births from assisted reproductive technology (ART) using the cryopreserved sperm were also documented RESULTS: Twenty-six men with NOA underwent micro-TESE between May 2014 and April 2018. Mean preoperative total testosterone level was 12.0 nmol/l (IQR 5.2) and follicle-stimulating hormone level 23.5 IU/l (IQR 15.6). Genetic testing was performed as part of the preoperative work-up in only 10 of the 26 patients. A specific cause of NOA was identified in 9 of the 26 patients and included Klinefelter syndrome (1 patient), Y-chromosome AZFc microdeletion (1 patient), undescended testicles (5 patients) and chemotherapy (2 patients). The average testicular volume was 9.05 ml (IQR 5.6), and the mean duration of surgery 95.8 minutes (IQR 28.0). The overall sperm retrieval rate was 34.6%. A single pregnancy and subsequent live birth were recorded from a total of eight cycles of intracytoplasmic sperm injection (ICSI): four female partners had one ICSI cycle each and two females underwent two cycles each. Frozen and thawed sperm was used in seven of the ICSI cycles and fresh sperm in one cycle CONCLUSION: In this South African series, sperm retrieval rates of micro-TESE for non-obstructive azoospermia were comparable to those reported internationally. Preoperative genetic testing should be increased to optimise the selection of surgical candidatesen_ZA
dc.description.versionPublisher's version
dc.format.extent5 pagesen_ZA
dc.identifier.citationZarrabi, A. D. & Kruger, T. F. 202). Microsurgical testicular sperm extraction for testicular failure : the South African experience and first successful pregnancy. South African Journal of Surgery, 59(2):52-56, doi:10.17159/2078-5151/2021/v59n2a3230en_ZA
dc.identifier.issn2078-5151 (online)
dc.identifier.issn0038-2361 (print)
dc.identifier.otherdoi:10.17159/2078-5151/2021/v59n2a3230
dc.identifier.urihttp://hdl.handle.net/10019.1/124391
dc.language.isoen_ZAen_ZA
dc.publisherMedpharm Publicationsen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTesticular sperm extraction -- Microsurgeryen_ZA
dc.subjectTesticular failureen_ZA
dc.subjectAssisted reproductive technologyen_ZA
dc.subjectNon-obstructive azoospermiaen_ZA
dc.titleMicrosurgical testicular sperm extraction for testicular failure: the South African experience and first successful pregnancyen_ZA
dc.typeArticleen_ZA
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