Microdissection TESE (MD-TESE) Does not Improve Sperm Retrieval Rate but Contributes to Favorable Pregnancy Rate in Non-Obstructive Azoospermic (NOA) Patients

Background and aims: microdissection testicular sperm extraction tese (md-tese), which can improve surgical sperm retrieval rate is widely applied in sperm retrieval surgery in non-obstructive azoospermic (noa) patients. we assessed whether md-tese can improve sperm retrieval rate as well as intracytoplasmic sperm injection (icsi) results.methods: a retrospective comparative study involving 86 noa patients who underwent 6-8 conventional multiple tese (c-tese) procedures was conducted. another 116 noa patients underwent md-tese. ctese and md-tese were employed for the bilateral testis via a median raphe incision under spinal or local anesthesia with spermatic block.results: motile sperm recovery was achieved in 26 (30.2%) and 30 (25.8%) patients with c-tese and mdtese, respectively. collected sperm was cryopreserved. all couples in which motile sperm was recovered received icsi utilizing frozen-thawed sperm samples. overall pregnancy rates of the c-tese and md-tese groups were 23% (6/26) and 40% (12/30), respectively. abortion was not observed in either group and healthy deliveries resulted. statistical differences in sperm recovery and pregnancy rate were not evident between the groups (p=0.495, p=0.182, respectively). moreover, no successful pre-operative predictors of sperm recovery were identified.conclusions: these data demonstrated that md-tese does not improve sperm recovery rate; however, md-tese contributes to favorable pregnancy rate in noa patients.