Redo testicular sperm aspiration (TESA) in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA).

BACKGROUND

Testicular sperm aspiration (TESA) is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility. We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA).

METHODS

This is a retrospective analysis of consecutive TESAs (primary and redo) for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center. We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit.

RESULTS

439 TESAs (366 primary and 73 redo) in men with severe OAT (n = 133) and OA (n = 306) were included. Men with OA had significantly higher sperm retrieval rate (SRR) and motile SRR compared to men with severe OAT (99% vs. 95% and 98% vs. 83%, respectively, p < 0.05). The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT (15% vs. 32% and 1.2 ± 0.5 vs. 1.4 ± 0.7, respectively, p < 0.05). In both groups, SRR, motile SRR, the requirement for multiple biopsies, and the total number of aspirates were not significantly different in primary compared to redo cases.

CONCLUSION

Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT. The data also demonstrate that a redo TESA in these men is as effective as a primary TESA, suggesting that areas of active spermatogenesis are preserved 6 months after TESA.