Clinical and endocrine follow-up of patients after testicular sperm extraction

Schill, Thilo; Bals-Pratsch, Monika; Küpker, Wolfgang; Sandmann, J.örg; Johannisson, Rainer; Diedrich, Klaus

doi:10.1016/S0015-0282(02)04663-0

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Volume 79, Issue 2 , Pages 281-286, February 2003

Clinical and endocrine follow-up of patients after testicular sperm extraction

Thilo Schill, M.D.
- Department of Gynecology and Obstetrics, Department II, Endocrinology and Reproductive Medicine, Medical University of Hannover, Oststadt Klinikum, Hannover, Germany
- Reprint requests: Thilo Schill, M.D., Medical University of Hannover, Oststadt Klinikum, Department of Gynecology and Obstetrics, Department II; Endocrinology and Reproductive Medicine, Podbielski Strasse 380, D-30659 Hannover, Germany (FAX: 49-511-9063411).
Monika Bals-Pratsch, M.D.
- Center for Endocrinology, Reproductive Medicine and Human Genetics, Regensburg, Germany
Wolfgang Küpker, M.D.
- Department of Gynecology and Obstetrics, Medical University of Lübeck, Lübeck, Germany
J.örg Sandmann, M.D.
- Departments of Urology, Medical University of Lübeck, Lübeck, Germany
Rainer Johannisson, M.D.
- Institute of Pathology, Medical University of Lübeck, Lübeck, Germany
Klaus Diedrich, M.D.
- Institute of Pathology, Medical University of Lübeck, Lübeck, Germany

Received 28 January 2002; received in revised form 25 July 2002; accepted 25 July 2002.

Abstract

Objective

To evaluate the risk of testicular damage from testicular biopsies that are carried out for testicular sperm extraction (TESE) in infertile men.

Design

Prospective controlled clinical study.

Setting

Academic hospital.

Patient(s)

Forty infertile males with azoospermia.

Intervention(s)

Examination of the clinical, endocrine, biochemical, and sonographic data in average after 18 months after TESE was performed.

Main outcome measure(s)

Measurements before and after TESE: hormone values, testicular size, morphologic characteristics, and power Doppler after scrotal sonography.

Result(s)

Comparison of preoperative and postoperative values of basal testosterone, FSH, LH, and estradiol levels did not reveal any differences. Twelve of 26 patients had subnormal testosterone values before TESE; 14 of 39 patients had subnormal levels afterward. Postoperative sonographic measurements showed no significant difference of the testicular volume as compared with the preoperative values. Results of power Doppler sonography revealed pathological conditions (n = 5) in patients with former iliacal or testicular operations.

Conclusion(s)

Endocrine testicular function and testicular size were not impaired after testicular biopsy when compared with preoperative data. However, patients with nonobstructive azoospermia seem to be at risk for androgen deficiency due to primary testicular failure after repeated testicular biopsies.

Keywords: Testicular biopsy, TESE, androgen deficiency, scrotal sonography