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Open Access Research article

Long term effects of micro-surgical testicular sperm extraction on androgen status in patients with non obstructive azoospermia

Karel Everaert1*, Ilse De Croo2, Wim Kerckhaert1, Peter Dekuyper1, Marc Dhont2, Josiane Van der Elst2, Petra De Sutter2, Frank Comhaire3, Ahmed Mahmoud3 and Nicolaas Lumen1

Author Affiliations

1 Department of Urology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium

2 Department of Gynaecology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium

3 Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium

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BMC Urology 2006, 6:9  doi:10.1186/1471-2490-6-9

Published: 20 March 2006

Abstract

Background

The aim of our study was to review the results of microsurgically performed testicular sperm extraction (TESE) and to evaluate its possible long term effects on serum testosterone (T).

Methods

We operated on 48 men (35 +/- 8 years) with non-obstructive azoospermia (NOA). If no spermatozoa were found following a micro epididymal sperm extraction (Silber et al., 1994) and testicular biopsy, testicular microdissection was performed or multiple microsurgical testicular biopsies were taken. The mean follow-up of the serum T was 2.4 +/- 1.1 years.

Results

Sperm was retrieved in 17/48 (35%) of the men. The per couple take home baby rate if sperm was retrieved was 4/17 (24%). Serum T decreased significantly at follow-up (p < 0.05) and 5/31 (16%) de novo androgen deficiencies developed

Conclusion

In patients with non-obstructive azoospermia in whom no spermatozoa were found following a micro epididymal sperm aspiration and a simple testicular biopsy, we were able to retrieve spermatozoa in 35% of the men. The take home baby rate was 24% among couples with spermatozoa present upon TESE. De novo androgen deficiency occurred in 16% of the male patients following TESE indicating that, in men with NOA, long term hormonal follow up is recommended after TESE.