J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 3, Number 3, June 2011, pages 124-131

Clinical Comparison of Conventional Testicular Sperm Extraction and Microdissection Techniques for Non-Obstructive Azoospermia

**Table 1.** A Comparison of Baseline Data Between Conventional Testicular Sperm Extraction (TESE) and Microdissection TESE Groups
	Conventional	Microdissection	P Value
Testing by Mann Whitney and chi-square
Age	35.4 ± 7.1	34.8 ± 8.5	0.4
Mean FSH (IU/L)	16.7 ± 14.2	19.7 ± 12.5	0.06
FSH (IU/L), n (%)			0.13
< 24	52 (76.5%)	42 (64.6%)
≥ 24	16 (23.5%)	23 (35.4%)
LH (IU/L)	11.1 ± 8.0	11.0 ± 7.6	0.8
TEST (ng/ml)	3.9 ± 2.2	4.3 ± 2.2	0.3
PROL (ug/L)	8.7 ± 4.1	8.7 ± 2.9	0.4
Testicular volume (ml)	11.9 ± 4.6	11.8 ± 4.1	1.0
Patients with varicocele, n (%)	9 (13.2)	10 (15.4)	0.7
Patients after orchidopexy, n (%)	3 (4.4)	3 (4.6)	1.0
Histopathological diagnosis, n (%)			0.7
Hypospermatogenesis	25 (36.8)	28 (43.1)
Maturation arrest	11 (16.2)	11 (16.9)
Sertoli cell-only syndrome	32 (47.1)	26 (40.0)

Table 1. A Comparison of Baseline Data Between Conventional Testicular Sperm Extraction (TESE) and Microdissection TESE Groups

Conventional

Microdissection

P Value

Testing by Mann Whitney and chi-square

Age

35.4 ± 7.1

34.8 ± 8.5

0.4

Mean FSH (IU/L)

16.7 ± 14.2

19.7 ± 12.5

0.06

FSH (IU/L), n (%)

0.13

< 24

52 (76.5%)

42 (64.6%)

≥ 24

16 (23.5%)

23 (35.4%)

LH (IU/L)

11.1 ± 8.0

11.0 ± 7.6

0.8

TEST (ng/ml)

3.9 ± 2.2

4.3 ± 2.2

0.3

PROL (ug/L)

8.7 ± 4.1

8.7 ± 2.9

0.4

Testicular volume (ml)

11.9 ± 4.6

11.8 ± 4.1

1.0

Patients with varicocele, n (%)

9 (13.2)

10 (15.4)

0.7

Patients after orchidopexy, n (%)

3 (4.4)

3 (4.6)

1.0

Histopathological diagnosis, n (%)

0.7

Hypospermatogenesis

25 (36.8)

28 (43.1)

Maturation arrest

11 (16.2)

11 (16.9)

Sertoli cell-only syndrome

32 (47.1)

26 (40.0)

**Table 2.** Sperm Retrieval Rate According to the Class of Plasma FSH Concentration, Testicular Volume and Histopathological Diagnosis
		Conventional	Microdissection	P value
H: hypospermatogenesis; MA: maturation arrest; SCOS: Sertoli cell-only syndrome; : statistically significant*
FSH (IU/L)	< 24	25/52 (48.1%)	28/42 (66.7%)	0.07
≥ 24	1/16 (6.2%)	9/23 (39.1%)	0.02*
Testicular volume (ml)	≤ 8	3/18 (16.7%)	5/17 (29.4%)	0.4
9 - 12	8/26 (30.8%)	15/27 (55.6%)	0.07
> 12	15/24 (62.5%)	17/21 (81.0%)	0.1
Pathology	H	21/25 (84.0%)	26/28 (92.9%)	0.3
MA	3/11 (27.3%)	4/11 (36.4%)	0.6
SCOS	2/32 (6.2%)	7/26 (26.9%)	0.03*
Total		26/68 (38.2%)	37/65 (56.9%)	0.03*

Table 2. Sperm Retrieval Rate According to the Class of Plasma FSH Concentration, Testicular Volume and Histopathological Diagnosis

Conventional

Microdissection

P value

H: hypospermatogenesis; MA: maturation arrest; SCOS: Sertoli cell-only syndrome; *: statistically significant

FSH (IU/L)

< 24

25/52 (48.1%)

28/42 (66.7%)

0.07

≥ 24

1/16 (6.2%)

9/23 (39.1%)

0.02*

Testicular volume (ml)

≤ 8

3/18 (16.7%)

5/17 (29.4%)

0.4

9 - 12

8/26 (30.8%)

15/27 (55.6%)

0.07

> 12

15/24 (62.5%)

17/21 (81.0%)

0.1

Pathology

21/25 (84.0%)

26/28 (92.9%)

0.3

3/11 (27.3%)

4/11 (36.4%)

0.6

SCOS

2/32 (6.2%)

7/26 (26.9%)

0.03*

Total

26/68 (38.2%)

37/65 (56.9%)

0.03*

**Table 3.** Assessment of Success of Both Micro TESE and Conventional TESE Using Binary Logistic Regression
Factor	Microdissection	Conventional	Total
*: statistically significant
Age	1.01	0.96 - 1.08	0.67	0.97	0.90 - 1.04	0.37	0.99	0.95 - 1.04	0.73
Histopathology
HS	1			1			1
MA	0.04	0.01 - 0.29	0.001*	0.07	0.01 - 0.39	0.002*	0.06	0.02 - 0.21	< 0.001*
SCO	0.03	0.01 - 0.15	< 0.001*	0.01	0.002 - 0.08	< 0.001*	0.02	0.01 - 0.07	< 0.001*
Testicular volume	1.31	1.08 - 1.59	0.006*	1.24	1.07 - 1.43	0.004*	1.25	1.12 - 1.40	< 0.001*
Testicular volume range
≤ 8	1			1			1
9 - 12	3.00	0.83 - 10.90	0.10	2.22	0.50 - 9.89	0.30	2.59	0.99 - 6.74	0.05*
> 12	10.2	2.26 - 46.1	0.003*	8.33	1.88 - 37.0	0.005*	8.31	3.00 - 23.01	< 0.001*
FSH	0.96	0.92 - 1.00	0.05*	0.82	0.75 - 0.90	< 0.001*	0.93	0.90 - 0.96	< 0.001*
FSH range
< 24	1			1			1
≥ 24	0.32	0.11 - 0.92	0.04*	0.07	0.01 - 0.59	0.01	0.27	0.12 - 0.61	0.002*
LH	0.99	0.93 - 1.05	0.72	0.73	0.61 - 0.87	0.001*	0.92	0.87 - 0.97	0.003*
Testosterone	1.06	0.84 - 1.33	0.64	1.18	0.94 - 1.48	0.16	1.13	0.96 - 1.32	0.14
Prolactin	0.94	0.79 - 1.11	0.46	1.01	0.89 - 1.13	0.93	0.98	0.89 - 1.08	0.73

Table 3. Assessment of Success of Both Micro TESE and Conventional TESE Using Binary Logistic Regression

Factor

Microdissection

Conventional

Total

CI (95%)

P-value

CI (95%)

P-value

CI (95%)

P-value

*: statistically significant

Age

1.01

0.96 - 1.08

0.67

0.97

0.90 - 1.04

0.37

0.99

0.95 - 1.04

0.73

Histopathology

0.04

0.01 - 0.29

0.001*

0.07

0.01 - 0.39

0.002*

0.06

0.02 - 0.21

< 0.001*

SCO

0.03

0.01 - 0.15

< 0.001*

0.01

0.002 - 0.08

< 0.001*

0.02

0.01 - 0.07

< 0.001*

Testicular volume

1.31

1.08 - 1.59

0.006*

1.24

1.07 - 1.43

0.004*

1.25

1.12 - 1.40

< 0.001*

Testicular volume range

≤ 8

9 - 12

3.00

0.83 - 10.90

0.10

2.22

0.50 - 9.89

0.30

2.59

0.99 - 6.74

0.05*

> 12

10.2

2.26 - 46.1

0.003*

8.33

1.88 - 37.0

0.005*

8.31

3.00 - 23.01

< 0.001*

FSH

0.96

0.92 - 1.00

0.05*

0.82

0.75 - 0.90

< 0.001*

0.93

0.90 - 0.96

< 0.001*

FSH range

< 24

≥ 24

0.32

0.11 - 0.92

0.04*

0.07

0.01 - 0.59

0.01

0.27

0.12 - 0.61

0.002*

0.99

0.93 - 1.05

0.72

0.73

0.61 - 0.87

0.001*

0.92

0.87 - 0.97

0.003*

Testosterone

1.06

0.84 - 1.33

0.64

1.18

0.94 - 1.48

0.16

1.13

0.96 - 1.32

0.14

Prolactin

0.94

0.79 - 1.11

0.46

1.01

0.89 - 1.13

0.93

0.98

0.89 - 1.08

0.73

**Table 4.** Assessment of Success of Microdissection TESE Compared to Conventional TESE Using Binary Logistic Regression
Microdissection TESE Combined With Other Factors	OR	CI (95%)	P-value
*: statistically significant
Alone	2.14	1.07 - 4.27	0.03*
Adjusted to FSH	3.54	1.55 - 8.08	0.003*
Adjusted to Testicular Volume	2.50	1.17 - 5.35	0.02*
Adjusted to Histopathology	2.96	1.10 - 7.99	0.03*
Adjusted to FSH and Testicular Volume	3.68	1.53 - 8.86	0.004*
Adjusted to FSH and Histopathology	3.47	1.25 - 9.60	0.01*
Adjusted to Testicular Volume and Histopathology	3.00	1.11 - 8.10	0.03*
Adjusted to FSH, Testicular Volume and Histopathology	3.56	1.28 - 9.92	0.02*

Table 4. Assessment of Success of Microdissection TESE Compared to Conventional TESE Using Binary Logistic Regression

Microdissection TESE Combined With Other Factors

CI (95%)

P-value

*: statistically significant

Alone

2.14

1.07 - 4.27

0.03*

Adjusted to FSH

3.54

1.55 - 8.08

0.003*

Adjusted to Testicular Volume

2.50

1.17 - 5.35

0.02*

Adjusted to Histopathology

2.96

1.10 - 7.99

0.03*

Adjusted to FSH and Testicular Volume

3.68

1.53 - 8.86

0.004*

Adjusted to FSH and Histopathology

3.47

1.25 - 9.60

0.01*

Adjusted to Testicular Volume and Histopathology

3.00

1.11 - 8.10

0.03*

Adjusted to FSH, Testicular Volume and Histopathology

3.56

1.28 - 9.92

0.02*