Volume 11, Issue 6 (9-2013)                   IJRM 2013, 11(6): 447-0 | Back to browse issues page

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Modarresi T, Sabbaghian M, Shahverdi A, Hosseinifar H, Akhlaghi A A, Sadighi Gilani M A. Enzymatic digestion improves testicular sperm retrieval in non-obstructive azoospermic patients. IJRM 2013; 11 (6) :447-0
URL: http://ijrm.ir/article-1-427-en.html
Enzymatic digestion improves testicular sperm retrieval in non-obstructive azoospermic patients
Tahereh Modarresi1 , Marjan Sabbaghian1 , Abdolhossein Shahverdi2 , Hani Hosseinifar1 , Ali Asghar Akhlaghi3 , Mohammad Ali Sadighi Gilani * 4
1- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
2- Department of Embryology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
3- Department of Epidemiology and Reproductive Health at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
4- Department of Andrology at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , masadighi@gmail.com
Abstract:   (2675 Views)
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
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Type of Study: Original Article |
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