Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-27T05:23:26.171Z Has data issue: false hasContentIssue false

Chapter 14 - Biopsy of Testicles

from Section 2 - Assisted Reproductive Procedures

Published online by Cambridge University Press:  05 March 2021

Edited by
Eliezer Girsh
Eliezer Girsh
Affiliation:
Barzilai Medical Center, Ashkelon
Get access

Summary

Historically, the absence or a small number of sperm cells in the ejaculate often precluded men from fathering their genetic progeny and relegated couples to the use of donor spermatozoa insemination or adoption or childlessness. With the development of intracytoplasmic sperm injection (ICSI), men with azoospermia (absence of sperm in the ejaculate) or severe oligozoospermia (less than 5 × 106 spermatozoa in the ejaculate) are able to father a child following single sperm cell injection into the cytoplasm of a single oocyte. In the years after the development of ICSI, it was discovered that sperm retrieved directly from testicular tissue can also be used for oocyte fertilization and enable healthy embryo development.

Type
Chapter
Information
A Textbook of Clinical Embryology , pp. 169 - 181
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Stephen, EH, Chandra, A. Declining estimates of infertility in the United States: 1982–2002. Fertil. Steril. 2006; 86:516–523.Google Scholar
Jarow, JP, Espeland, MA, Lipshultz, LI. Evaluation of the azoospermic patient. J. Urol. 1989; 142:62–65.CrossRefGoogle ScholarPubMed
Dohle, GR, Halley, DJ, Van Hemel, JO et al. Genetic risk factors in infertile men with severe oligozoospermia and azoospermia. Hum. Reprod. 2002; 17:13–16.Google Scholar
Desai, N, Gill, P, Tadros, NN, et al. Azoospermia and embryo morphokinetics: testicular sperm-derived embryos exhibit delays in early cell cycle events and increased arrest prior to compaction. J. Assist. Reprod. Genet. 2018; 35:1339–1348.Google Scholar
Carpi, A, Sabanegh, E, Mechanick, J. Controversies in the management of nonobstructive azoospermia. Fertil. Steril. 2009; 91:963–970.CrossRefGoogle ScholarPubMed
Singer, R, Sagiv, M, Barnet, M, Levinsky, H. Semen volume and fructose content of human semen. Survey of the years 1980–1989. Acta Eur. Fertil. 1990; 21:205–206.Google Scholar
Paick, J, Kim, SH, Kim, SW. Ejaculatory duct obstruction in infertile men. BJU Int. 2000; 85:720–724.CrossRefGoogle ScholarPubMed
Roberts, M, Jarvi, K. Steps in the investigation and management of low semen volume in the infertile man. Can. Urol. Assoc. J. 2009; 3:479–485.Google Scholar
Schlegel, PN, Shin, D, Goldstein, M. Urogenital anomalies in men with congenital absence of the vas deferens. J. Urol. 1996; 155:1644–1648.CrossRefGoogle ScholarPubMed
Hall, S, Oates, RD. Unilateral absence of the scrotal vas deferens associated with contralateral mesonephric duct anomalies resulting in infertility: laboratory, physical and radiographic findings, and therapeutic alternatives. J. Urol. 1983; 50:1161–1164.Google Scholar
Chillon, M, Casals, T, Mercier, B, et al. Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens. N. Engl. J. Med. 1995; 332:1475–1480.Google Scholar
Yu, J, Chen, Z, Ni, Y, Li, Z. CFTR mutations in men with congenital bilateral absence of the vas deferens (CBAVD): a systemic review and meta-analysis. Hum. Reprod. 2012; 27:25–35.Google Scholar
McCallum, T, Milunsky, J, Munarriz, R, et al. Unilateral renal agenesis associated with congenital bilateral absence of the vas deferens: phenotypic findings and genetic considerations. Hum. Reprod. 2001; 16:282–288.Google Scholar
Schwarzer, JU, Schwarz, M. Significance of CFTR gene mutations in patients with congenital aplasia of vas deferens with special regard to renal aplasia. Andrologia 2012; 44:305–307.Google Scholar
Meng, MV, Black, LD, Cha, I, et al. Impaired spermatogenesis in men with congenital absence of the vas deferens. Hum. Reprod. 2001; 16:529–533.CrossRefGoogle ScholarPubMed
Friedler, S, Raziel, A, Schachter, M, et al. Outcome of first and repeated testicular sperm extraction and ICSI in patients with non-obstructive azoospermia. Hum. Reprod. 2002; 17:2356–2361.Google Scholar
Matsumiya, K, Namiki, M, Takahara, S, et al. Clinical study of azoospermia. Int. J. Androl. 1994; 17:140–142.Google Scholar
Faes, K, Goossens, E. Short-term storage of human testicular tissue: effect of storage temperature and tissue size. RBM Online 2017; 35:180–188.Google Scholar
Krege, S, Beyer, J, Souchon, R, et al. European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG). Ann. Oncol. 2004; 15:1377–1399.Google Scholar
Honig, SC, Lipshulz, LI, Jarow, J. Significant medical pathology uncovered by a comprehensive male infertility evaluation. Fertil. Steril. 1994; 62:1028–1034.CrossRefGoogle ScholarPubMed
Shefi, S, Turek, PJ. Definition and current evaluation of subfertile men. Int. Braz. J. Urol. 2006; 32:385–397.Google Scholar
Dohle, GR, Elzanaty, S, van Casteren, NJ. Testicular biopsy: clinical practice and interpretation. Asian J. Androl. 2012; 14:88–93.CrossRefGoogle ScholarPubMed
Donoso, P, Tournaye, H, Devroey, P. Which is the best sperm retrieval technique for nonobstructive azoospermia? A systematic review. Hum. Reprod. Update 2007; 13:539–549.Google Scholar
Schlegel, PN, Su, LM. Physiological consequences of testicular sperm extraction. Hum. Reprod. 1997; 12:1688–1692.Google Scholar
Pilatz, A, Rusz, A, Wagenlehner, F, Weidner, W, Altinkilic, B. Reference values for testicular volume, epididymal head size and peak systolic velocity of the testicular artery in adult males measured by ultrasonography. Ultraschall Med. 2013; 34:349–354.Google Scholar
Tsirigotis, M, Bennett, V, Nicholson, N, et al. Experience with subzonal insemination (SUZI) and intracytoplasmic sperm injection (ICSI) on unfertilized aged human oocytes. J. Assist. Reprod. Genet. 1994; 11:389–394.Google Scholar
Henkel, RR, Schill, WB. Sperm preparation for ART. Reprod. Biol. Endocrinol. 2003; 1:108–122.Google Scholar
Kovacic, B, Vlaisavljevic, V, Reljic, M. Clinical use of pentoxifylline for activation of immotile testicular sperm before ICSI in patients with azoospermia. J. Androl. 2006; 27:45–52.Google Scholar
Caroppo, E, Colpi, EM, Gazzano, G, et al. Testicular histology may predict the successful sperm retrieval in patients with non-obstructive azoospermia undergoing conventional TESE: a diagnostic accuracy study. J. Assist. Reprod. Genet. 2017; 34:149–154.Google Scholar
Selice, R, Di Mambro, A, Garolla, A, et al. Spermatogenesis in Klinefelter syndrome. J. Endocrinol. Invest. 2010; 33:789–793.Google Scholar
Ostad, M, Liotta, D, Ye, Z, Schlegel, PN. Testicular sperm extraction for nonobstructive azoospermia: results of a multibiopsy approach with optimized tissue dispersion. Urology 1998; 52:692–696.Google Scholar
Schlegel, PN, Li, PS. Microdissection TESE: sperm retrieval in non-obstructive azoospermia. Hum. Reprod. Update 1998; 4:439.Google Scholar
Schlegel, PN. Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum. Reprod. 1999; 14:131–135.CrossRefGoogle ScholarPubMed
Turunc, T, Gul, U, Haydardedeoglu, B, et al. Conventional testicular sperm extraction combined with the microdissection technique in nonobstructive azoospermic patients: a prospective comparative study. Fertil. Steril. 2010; 94:2157–2160.Google Scholar
Jensen, CFS, Ohl, DA, Hiner, MR, et al. Multiple needle-pass percutaneous testicular sperm aspiration as first line treatment in azoospermic men. Andrology 2016; 4:257–262.Google Scholar
Eliveld, J, van Wely, M, Meibner, A, et al. The risk of TESE-induced hypogonadism: a systematic review and meta-analysis. Hum. Reprod. Update 2018; 24:442–454.CrossRefGoogle ScholarPubMed
Kalsi, J, Thum, MY, Muneer, A, Abdullah, H, Minhas, S. In the era of micro-dissection sperm retrieval (m-TESE) is an isolated testicular biopsy necessary in the management of men with non-obstructive azoospermia? BJU Int. 2012; 109:418–424.Google Scholar
Bernie, AM, Mata, DA, Ramasamy, R, Schlegel, PN. Comparison of microdissection testicular sperm extraction, conventional testicular sperm extraction, and testicular sperm aspiration for nonobstructive azoospermia: a systematic review and meta-analysis. Fertil. Steril. 2015; 104:1099–1103.CrossRefGoogle ScholarPubMed
Deruyver, Y, Vanderschueren, D, Van der Aa, F. Outcome of microdissection TESE compared with conventional TESE in non-obstructive azoospermia: a systematic review. Andrology 2014; 2:20–24.Google Scholar
Caroppo, E, Colpi, EM, Gazzano, G, et al. The seminiferous tubule caliber pattern as evaluated at high magnification during microdissection testicular sperm extraction predicts sperm retrieval in patients with nonobstructive azoospermia. Andrology 2019; 7:8–14.CrossRefGoogle Scholar
Amer, M, Zohdy, W, Abd El Naser, T, et al. Single tubule biopsy: a new objective microsurgical advancement for testicular sperm retrieval in patients with nonobstructive azoospermia. Fertil. Steril. 2008; 89:592–596.CrossRefGoogle ScholarPubMed
Hussein, A, Ozgok, Y, Ross, L, Niederberger, C. Clomiphene administration for cases of nonobstructive azoospermia: a multicenter study. J. Androl. 2005; 26:787–791; discussion 792–793.CrossRefGoogle ScholarPubMed
Shiraishi, K, Ohmi, C, Shimabukuro, T, Matsuyama, H. Human chorionic gonadotrophin treatment prior to microdissection testicular sperm extraction in non-obstructive azoospermia. Hum. Reprod. 2012; 27:331–339.Google Scholar
Reifsnyder, JE, Ramasamy, R, Husseini, J, Schlegel, PN. Role of optimizing testosterone before microdissection testicular sperm extraction in men with nonobstructive azoospermia. J. Urol. 2012; 188:532–536.Google Scholar
Esteves, SC, Miyaoka, R, Roque, M, Agarwal, A. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J. Androl. 2016; 18:246–253.Google Scholar
Kirby, EW, Wiener, LE, Rajanahally, S, Crowell, K, Coward, RM. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil. Steril. 2016; 106:1338–1343.CrossRefGoogle ScholarPubMed
Ramasamy, R, Yagan, N, Schlegel, PN. Structural and functional changes to the testis after conventional versus microdissection testicular sperm extraction. Urology 2005; 65:1190–1194.CrossRefGoogle Scholar
Tournaye, H, Verheyen, G, Nagy, P, et al. Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum. Reprod. 1997; 12:80–86.Google Scholar
Verhoeven, G, Cailleau, J. Follicle-stimulating hormone and androgens increase the concentration of the androgen receptor in Sertoli cells. Endocrinology 1988; 122:1541–1550.Google Scholar
Kim, ED, Crosnoe, L, Bar-Chama, N, Khera, M, Lipshultz, L. The treatment of hypogonadism in men of reproductive age. Fertil. Steril. 2013; 99:718–724.Google Scholar
Pitteloud, N, Hayes, FJ, Dwyer, A, et al. Predictors of outcome of long-term GnRH therapy in men with idiopathic hypogonadotropic hypogonadism. J. Clin. Endocrinol. Metab. 2002; 87:4128–4136.Google Scholar
Adamopoulos, DA, Pappa, A, Billa, E, et al. Effectiveness of combined tamoxifen citrate and testosterone undecanoate treatment in men with idiopathic oligozoospermia. Fertil. Steril. 2003; 80:914–920.CrossRefGoogle ScholarPubMed
Rodrigo, L, Rubio, C, Peinado, V, et al. Testicular sperm from patients with obstructive and nonobstructive azoospermia: aneuploidy risk and reproductive prognosis using testicular sperm from fertile donors as control samples. Fertil. Steril. 2011; 95:1005–1012.Google Scholar
Vozdova, M, Heracek, J, Sobotka, V, Rubes, J. Testicular sperm aneuploidy in non-obstructive azoospermic patients. Hum. Reprod. 2012; 27:2233–2239.Google Scholar
Schlegel, PN. Male infertility: evaluation and sperm retrieval. Clin. Obstet. Gynecol. 2006; 49:55–72.Google Scholar
Samli, H, Samli, MM, Solak, M, Imirzalioglu, N. Genetic anomalies detected in patients with non-obstructive azoospermia and oligozoospermia. Arch. Androl. 2006; 52:263–267.Google Scholar
Pryor, JL, Kent-First, M, Muallem, A, et al. Microdeletions in the Y chromosome of infertile men. N. Engl. J. Med. 1997; 336:534–539.Google Scholar
Oates, RD, Silber, S, Brown, LG, Page, DC. Clinical characterization of 42 oligospermic or azoospermic men with microdeletion of the AZFc region of the Y chromosome, and of 18 children conceived via ICSI. Hum. Reprod. 2002; 17:2813–2824.Google Scholar
Hopps, CV, Mielnik, A, Goldstein, M, et al. Detection of sperm in men with Y chromosome microdeletions of the AZFa, AZFb and AZFc regions. Hum. Reprod. 2003; 18:1660–1665.Google Scholar
Lee, SH, Ahn, SY, Lee, KW, et al. Intracytoplasmic sperm injection may lead to vertical transmission, expansion, and de novo occurrence of Y-chromosome microdeletions in male fetuses. Fertil. Steril. 2006; 85:1512–1515.Google Scholar
Practice Committee for the ASRM. Evaluation of the azoospermic male: a committee opinion. Fertil. Steril. 2018; 109:777–782.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Biopsy of Testicles
  • Edited by Eliezer Girsh
  • Book: A Textbook of Clinical Embryology
  • Online publication: 05 March 2021
  • Chapter DOI: https://doi.org/10.1017/9781108881760.015
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Biopsy of Testicles
  • Edited by Eliezer Girsh
  • Book: A Textbook of Clinical Embryology
  • Online publication: 05 March 2021
  • Chapter DOI: https://doi.org/10.1017/9781108881760.015
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Biopsy of Testicles
  • Edited by Eliezer Girsh
  • Book: A Textbook of Clinical Embryology
  • Online publication: 05 March 2021
  • Chapter DOI: https://doi.org/10.1017/9781108881760.015
Available formats
×