Identifying infertile men who may be amenable to a limited testicular dissection at microdissection testicular sperm extraction

Introduction

We aimed to compare clinical characteristics of men with non-obstructive azoospermia (NOA) and cryptozoospermia with a successful sperm retrieval after a limited dissection micro-TESE to identify clinical parameters that may help find patients most likely to undergo a limited dissection.

Methods

We retrospectively analyzed a prospective database of 208 infertile men undergoing a first microdissection testicular sperm extraction (micro-TESE) at a high-volume fertility center (March 2015 to June 2025). The stepwise approach begins with five targeted micro-biopsies through a 1 cm tunica albuginea incision. The incision is extended only if sperm are not initially identified.

Results