Laterality Success Determination of Microscopic Testicular Sperm Extraction in Non Obstructive Azoopsermia Patients

NCT ID: NCT07259967

Last Updated: 2025-12-02

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 80 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-12-31
• Study Completion Date: 2027-01-31

Brief Summary

Determination of percentage of successful sperm retrieval in single testis in cases who will do bilateral TESE and identification factors mostly associated with successful sperm retrieval

Detailed Description

Male infertility is defined as the failure of pregnancy within 12 months despite the presence of a fertile female partner and coitus via a normal vaginal route without contraception. The microscopic absence of spermatozoa in the ejaculate in at least two semen analysis samples is defined as azoospermia. Azoospermia plays a role in the etiology of male infertility with a rate of 10-15% . Azoospermia is divided into two subgroups: obstructive azoospermia (OA) and non obstructive azoospermia (NOA). NOA is detected in 60% of patients with azoospermia. The etiopathogenesis of NOA includes genetic disorders, Y chromosome microdeletions, testicular torsion, cryptorchidism, toxins, radiation and idiopathic factors. Although many techniques including Percutaneous Sperm Aspiration , Testicular Sperm Aspiration , Conventional Testicular Sperm Extraction , Microdissection Testicular Sperm Extraction (MD-TESE) have been used to detect sperm in patients with NOA, MD-TESE is currently accepted as the method with the highest sperm retrieval rate with the least complications and tissue loss. However, no standard approach is available for searching for appropriate tubules during the MD-TESE procedure . A limited number of studies are available in the literature on whether the testicle should be explored transversely or longitudinally, bilaterally or unilaterally, to increase the sperm detection rate in MD-TESE, and there is still no standard systematic procedure for MD-TESE today to minimize the possibility of missing appropriate tubules and obtaining sperm. Furthermore, despite the presence of studies in the literature indicating that parameters such as hormonal values, testicular volume, genetics, age, environmental factors, varicocele and cryptorchidism predict the possibility of finding sperm before the MD-TESE procedure, none of these parameters have a definite predictive value on sperm finding . The present study aims to evaluate if there is difference in testicular sperm retrieval in patients with non obstructive azoospermia in TESE between right and left testes.

Conditions

Testicular Sperm Extraction in Azoospermic Patients

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Interventions

Testicular sperm extraction

Bilateral Testicular sperm extraction done under microscopic guidance for non obstructive azoospermic patients

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• • Male patients diagnosed as non obstructive azoospermia.

• Will do bilateral TESE.

Exclusion Criteria

• • Obstructive azoospermia.

• Incomplete medical record .
• Prior testicular Trauma.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

mohamed diab mohamed ramadan

Assistant Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mohamed Diab Mohamed Ramadan, Master

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Central Contacts

Mohamed Diab, Master

Role: CONTACT

md01147169166@gmail.com

01005886962

Mohamed D Mohamed, Master

Role: CONTACT

md01501501772@gmail.com

01501501772

References

Raman JD, Schlegel PN. Testicular sperm extraction with intracytoplasmic sperm injection is successful for the treatment of nonobstructive azoospermia associated with cryptorchidism. J Urol. 2003 Oct;170(4 Pt 1):1287-90. doi: 10.1097/01.ju.0000080707.75753.ec.

Reference Type: RESULT

PMID: 14501743 (View on PubMed)

Levin HS. Testicular biopsy in the study of male infertility: its current usefulness, histologic techniques, and prospects for the future. Hum Pathol. 1979 Sep;10(5):569-84. doi: 10.1016/s0046-8177(79)80100-8.

Reference Type: RESULT

PMID: 43278 (View on PubMed)

Witt MA, Elsner C, Kort HI, Massey JB, Mitchell-Leef D, Toledo AA, Tucker MJ. A live birth from intracytoplasmic injection of a spermatozoon retrieved from testicular parenchyma. J Urol. 1995 Sep;154(3):1136-7. No abstract available.

Reference Type: RESULT

PMID: 7637066 (View on PubMed)

Ichioka K, Matsui Y, Terada N, Negoro H, Goto T, Ogawa O. Three-dimensional simulation analysis of microdissection testicular sperm extraction for patients with non-obstructive azoospermia. Andrology. 2020 Sep;8(5):1214-1221. doi: 10.1111/andr.12812. Epub 2020 May 18.

Reference Type: RESULT

PMID: 32374923 (View on PubMed)

Other Identifiers

Laterality of micro TESE

Identifier Type: -

Identifier Source: org_study_id