Study Status: Not yet recruiting
Recruit Status: Not yet recruiting
Study Type: Interventional
Official Title: Is Surgical Microscope Essential for Sperm Retreival in Non-obstructive Azoospermia Patients? (Multicenters Study)
Brief Summary: Azoospermia is complete absence of sperm in the ejaculate. It accounts for 10-15% of male infertility cases. It is classified as obstructive and non-obstructive azoospermia (NOA). NOA constitutes 60% of all cases of azoospermia. Testicular sperm extraction (TESE) for intracytoplas¬mic sperm injection (ICSI) was first introduced for treatment of obstructive azoospermia in 1993. Soon afterwards testicular sperm were retrieved successfully and used in ICSI in cases of NOA. In the NOA cases, TESE combined with ICSI has been proven to be an acceptable line of treatment. Microdissection TESE may have some theoretical benefits over conventional TESE, but uncertainty exists about its superiority. During a conventional TESE procedure, the testis is exposed through a small incision and one or multiple biopsies are taken blindly. Micro TESE was first introduced in 1999. In this technique, the tunica albuginea is widely opened and examination of the testicular tissue is carried out at 20-25× magnification under an operating microscope allowing visualization of whitish, larger and more opaque tubuli. The concept of this technique is that these tubuli are more likely to contain active spermatogenesis. Another possible benefit is better identification of sub-tunical vessels reducing risk of devascularization. several studies have been conducted comparing the efficacy of conventional and micro TESE revealed that there is a tendency towards higher sperm retrieval rate (SRR) in microTESE versus conventional TESE also no secure clinical predictors of (SR) are demonstrated for both procedures and although fewer sonographical complications occur after microTESE, clinical complication rate between both procedures seems not to differ.