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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Reproduction
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1466675
This article is part of the Research Topic Fertility Preservation and Restoration in Oncologic and Non-Oncologic Patients View all 3 articles

Rate of testicular histology failure in predicting successful testicular sperm extraction (TESE)

Provisionally accepted
Stefano Castellano Stefano Castellano 1*Francesca Tondo Francesca Tondo 1Ozgur Bulbul Ozgur Bulbul 1Sabrina Aprea Sabrina Aprea 1Emanuela Monti Emanuela Monti 1Edoardo Carnesi Edoardo Carnesi 1Paolo E. Levi Setti Paolo E. Levi Setti 1,2ELENA ALBANI ELENA ALBANI 1
  • 1 1Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, IRCCS Humanitas Research Hospital,, Rozzano, Italy
  • 2 Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy

The final, formatted version of the article will be published soon.

    This is a retrospective analysis of 526 TESE patients. We compared our evaluations, in terms of retrieved sperm concentration and number of cryopreserved paillettes for any patients, with testicular histology reports. This way we tried to gain a better understanding of the different criteria used by the two laboratory techniques. After the extraction of the testis, the resulting sample was immediately given to the embryologist, who examined the tubules for sperm cryopreservation. During the same procedure, a different specimen was destined to the histological analysis. The comparison between the two methodological approaches was carried out through a score. Concordance between TESE and testicular histology outcomes was found in 70,7% of patients; discordance was found in 29,3% of patients. Among the discordance outcomes, in approximately 95% we found at least 1 sperm in the TESE retrieval, while the histology report did not find any spermatozoa or found not enough compared to our evaluation; in only 5% of cases we did not find any spermatozoa or found not enough compared to what was detected in the testicular histology. The main limitation of this study lies in the techniques used to achieve the results. Sperm cryopreservation gives quantitative results, in terms of sperm concentration and number of cryopreserved paillettes; on the other hand, the histopathology report is based on a qualitative examination. Based on our experience, to increase diagnostic accuracy, a larger biopsy should be sent to the histopathology laboratory; another option may be to use TESE cell suspension (the same embryologists employ for cryopreservation) for cytological evaluation of spermatogenesis.

    Keywords: non-obstructive azoospermia, NOA, Obstructive azoospermia, OA, Testicular biopsy, Testicular histology, Fertility Preservation, Cryopreservation

    Received: 18 Jul 2024; Accepted: 11 Sep 2024.

    Copyright: © 2024 Castellano, Tondo, Bulbul, Aprea, Monti, Carnesi, Levi Setti and ALBANI. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Stefano Castellano, 1Division of Gynecology and Reproductive Medicine, Department of Gynecology, Fertility Center, IRCCS Humanitas Research Hospital,, Rozzano, Italy

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