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Iranian Journal of Reproductive Medicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
ISSN: 1680-6433
EISSN: 2008-2177
Vol. 11, No. 6, 2013, pp. 447-452
Bioline Code: rm13056
Full paper language: English
Document type: Editorial
Document available free of charge

Iranian Journal of Reproductive Medicine, Vol. 11, No. 6, 2013, pp. 447-452

 en Enzymatic digestion improves testicular sperm retrieval in non-obstructive azoospermic patients
Modarresi, Tahereh; Sabbaghian, Marjan; Shahverdi, Abdolhossein; Hosseinifar, Hani; Akhlaghi, Ali Asghar & Gilani, Mohammad Ali Sadighi

Abstract

Background: In patients with non-obstructive azoospermia (NOA), vital spermatozoa from the tissue is obtained from testes by enzymatic treatment besides the mechanical treatment.
Objective: To increase the sperm recovery success of testicular sperm extraction (TESE), with enzymatic digestion if no sperm is obtained from testis tissue by mechanical method.
Materials and Methods: Tissue samples were collected from 150 men who presented with clinical and laboratory data indicating NOA by means of TESE and micro dissection TESE methods. Initially, mature spermatozoa were examined for by mechanical extraction technique shredding the biopsy fractions. In cases whom no spermatozoa was observed after maximum 30 min of initial searching under the inverted microscope, the procedure was followed by enzymatic digestion using DNaseI and collagenase type IV. Surgery type, pathology, AZF, karyotype, hormones and testis size were compared in patients.
Results: Of 150 cases with NOA, conventional mincing method extended with enzymatic treatment yielded successful sperm recovery in 13 (about 9%) patients. Comparison of parameters revealed that level of FSH and LH were significantly different (p=0.04 and 0.08 respectively) between two groups that response negative and positive to enzymatic digestion.
Conclusion: The combination of conventional TESE and enzymatic digestion is an effective method to recover spermatozoa. The benefit of the mincing combined with enzyme to sperm retrieval for NOA firstly shorten the mechanical searching time, leading to minimizing further cellular damage as well as exposure to external conditions, and secondly reduce the number of cases with sperm recovery failures. Also, the serum level of FSH and LH are factors that influence the chance of sperm retrieval.

Keywords
TESE; Enzymatic digestion; Non-obstructive azoospermia; FSH; LH

 
© Iranian Journal of Reproductive Medicine
Alternative site location: http://www.ijrm.ir

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