CONTROLLED COMPARISON OF PERCUTANEOUS AND MICROSURGICAL SPERM RETRIEVAL IN MEN WITH OBSTRUCTIVE AZOOSPERMIA

A controlled comparison of the efficacy and reliability of sperm retri eval by testicular fine needle aspiration (TFNA), percutaneous testicu lar needle biopsy (PercBiopsy) and microsurgical epididymal sperm aspi ration (MESA) was performed int nine patients with obstructive azoospe rmia. During a planned MESA procedure, sperm retrieval was attempted o n the same testis with TFNA and PercBiopsy. Spermatozoa were obtained from all patients using MESA and PercBiopsy, Spermatozoa were retrieve d using TFNA from 6/9 (67 %) men. The mean number of epididymal sperma tozoa retrieved with MESA (15 x 10(6)) was significantly higher (P = 0 .003) than that retrieved percutaneously from the testis, The mean num ber of spermatozoa obtained by PercBiopsy was 0.116x10(6) while TFNA r ecovered 0.014 x 10(6) spermatozoa (P = 0.025), MESA is the optimal ch oice to retrieve the greatest number of spermatozoa with highest motil ity for assisted reproduction and subsequent cryopreservation. However , percutaneous testicular retrieval does not require microsurgical exp ertise and is less invasive. Our results suggest that the optimal perc utaneous procedure for sperm retrieval from the testis involves percut aneous testicular needle biopsy with an automatic biopsy gun.