PHYSIOLOGICAL CONSEQUENCES OF TESTICULAR SPERM EXTRACTION

Testicular sperm extraction (TESE) may provide spermatozoa for attempt s at fertility with assisted reproduction; however the physiological e ffects of TESE on testicular function are not well understood, In orde r to evaluate the effects of TESE on the testis, 64 patients were eval uated after TESE for non-obstructive azoospermia with physical examina tions, serial scrotal sonography, histological analyses and evaluation of the success of repeated sperm retrieval attempts, At 3 months afte r TESE, 82% of evaluated patients had ultrasonographic abnormalities i n the testis suggesting resolving inflammation or haematoma at the bio psy site, By 6 months, these acute inflammatory changes typically reso lved leaving linear scars or calcifications, Two patients had document ed impaired testicular blood flow, with complete devascularization of the testis for one patient after TESE with multiple biopsies, Repeat T ESE procedures were far more likely to retrieve spermatozoa if the sec ond TESE attempt was performed >6 months after the initial TESE proced ure (80%), relative to those performed within 6 months (25%), Transien t adverse physiological effects are common in the testis for up to 6 m onths after TESE, In addition, permanent devascularization of the test is can occur following TESE procedures with multiple biopsies, The ris k of this complication may be minimized by using an open biopsy techni que with optical magnification to directly identify testicular vessels .