Clinical and endocrine follow-up of patients after testicular sperm extraction

Objective: To evaluate the risk of testicular damage from testicular biopsies that are carried out for testicular sperm extraction (TESE) in infertile men. Design: Prospective controlled clinical study. Setting: Academic hospital. Patient(s): Forty infertile males with azoospermia. Intervention(s): Examination of the clinical, endocrine, biochemical, and sonographic data in average after 18 months after TESE was performed. Main Outcome Measure(s): Measurements before and after TESE: hormone values, testicular size, morphologic characteristics, and power Doppler after scrotal sonography. Result(s): Comparison of preoperative and postoperative values of basal testosterone, FSH, LH, and estradiol levels did not reveal any differences. Twelve of 26 patients had subnormal testosterone values before TESE; 14 of 39 patients had subnormal levels afterward. Postoperative sonographic measurements showed no significant difference of the testicular volume as compared with the preoperative values. Results of power Doppler sonography revealed pathological conditions (n = 5) in patients with former iliacal or testicular operations. Conclusion(s): Endocrine testicular function and testicular size were not impaired after testicular biopsy when compared with preoperative data. However, patients with nonobstructive azoospermia seem to be at risk for androgen deficiency due to primary testicular failure after repeated testicular biopsies. (C) 2003 by American Society for Reproductive Medicine.