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Micro-TESE, Egnatia 67, Thessaloníki (2025)

09/10/2021

👉Preoperative preparation for micro-TESE procedure:

☑️Before surgery, at least 𝘁𝘄𝗼 𝘀𝗲𝗺𝗲𝗻 𝗮𝗻𝗮𝗹𝘆𝘀𝗲𝘀 have been performed to confirm azoos***mia.
☑️Moreover, 𝘀𝗲𝗿𝘂𝗺-𝗙𝗦𝗛, 𝗟𝗛, 𝘁𝗲𝘀𝘁𝗼𝘀𝘁𝗲𝗿𝗼𝗻𝗲 𝗮𝗻𝗱 𝗦𝗛𝗕𝗚 𝗰𝗼𝗻𝗰𝗲𝗻𝘁𝗿𝗮𝘁𝗶𝗼𝗻𝘀 have been analyzed to distinguish between obstructive and non-obstructive azoos***mia and to exclude hypogonadism.
☑️𝗔 𝗽𝗵𝘆𝘀𝗶𝗰𝗮𝗹 𝗶𝗻𝘃𝗲𝘀𝘁𝗶𝗴𝗮𝘁𝗶𝗼𝗻 has been performed measuring testicular volume with an orchidometer, and 𝘁𝗲𝘀𝘁𝗶𝗰𝘂𝗹𝗮𝗿 𝘂𝗹𝘁𝗿𝗮𝘀𝗼𝗻𝗼𝗴𝗿𝗮𝗽𝗵𝘆 to exclude scrotal abnormalities such as varicocele, epididymal/testicular cysts, hydrocele, and testicular tumours. ☑️Finally, 𝗮 𝗸𝗮𝗿𝘆𝗼𝘁𝘆𝗽𝗲 has been analyzed in most NOA men, and screening for Y-chromosomal microdeletions carried out as well.

05/09/2021

ℹ️Non-obstructive azoos***mia can be subdivided into pretesticular and testicular causes.

𝗣𝗿𝗲𝘁𝗲𝘀𝘁𝗶𝗰𝘂𝗹𝗮𝗿 𝗡𝗼𝗻-𝗢𝗯𝘀𝘁𝗿𝘂𝗰𝘁𝗶𝘃𝗲 𝗔𝘇𝗼𝗼𝘀𝗽𝗲𝗿𝗺𝗶𝗮: All pretesticular conditions disrupt the hormones a man needs for normal s***m creation. If a man has any of the following conditions, he can’t produce healthy, normal s***m.

𝗖𝗮𝘂𝘀𝗲𝘀 𝗼𝗳 𝗽𝗿𝗲𝘁𝗲𝘀𝘁𝗶𝗰𝘂𝗹𝗮𝗿 𝗻𝗼𝗻-𝗼𝗯𝘀𝘁𝗿𝘂𝗰𝘁𝗶𝘃𝗲 𝗮𝘇𝗼𝗼𝘀𝗽𝗲𝗿𝗺𝗶𝗮 𝗶𝗻𝗰𝗹𝘂𝗱𝗲:

➡️Hypogonadotropic hypogonadism—This is a problem with the pituitary gland where it doesn’t produce the hormones needed to create s***m or testosterone
➡️Hypothyroidism
➡️Use of certain medications.
➡️Elevated estradiol.
➡️Kallman’s syndrome.
➡️Certain rare types of pituitary tumors.

These conditions can usually be treated through oral or injectable medication.

15/08/2021

➡️𝗧𝗵𝗲 𝗽𝗮𝘁𝗶𝗲𝗻𝘁 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗮𝗯𝗹𝗲 𝘁𝗼 𝗹𝗲𝗮𝘃𝗲 𝗵𝗼𝘀𝗽𝗶𝘁𝗮𝗹 𝘀𝗵𝗼𝗿𝘁𝗹𝘆 𝗮𝗳𝘁𝗲𝗿 𝘁𝗵𝗲 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗲 𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝗼𝗻. You should be driven home by someone, especially because judgement is impaired after anesthetics, which can also cause some sore throat, jaw discomfort or muscle aches for 1-2 days.
➡️In the same day, it is advised to 𝗯𝗲𝗴𝗶𝗻 𝗱𝗿𝗶𝗻𝗸𝗶𝗻𝗴 𝗰𝗹𝗲𝗮𝗿 𝗹𝗶𝗾𝘂𝗶𝗱𝘀 𝗮𝗻𝗱 𝗮𝘃𝗼𝗶𝗱 𝗮𝗻𝘆 𝗵𝗲𝗮𝘃𝘆 𝗺𝗲𝗮𝗹𝘀.
➡️For the pain control, 𝘁𝗵𝗲 𝗱𝗼𝗰𝘁𝗼𝗿 𝗽𝗿𝗲𝘀𝗰𝗿𝗶𝗯𝗲𝘀 𝗮𝗻𝗮𝗹𝗴𝗲𝘀𝗶𝗰𝘀; the pain usually doesn’t last more than 5-7 days.
➡️𝗧𝗵𝗲 𝗽𝗵𝘆𝘀𝗶𝗰𝗮𝗹 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗹𝗶𝗺𝗶𝘁𝗲𝗱 𝗶𝗻 𝘁𝗵𝗲 𝗳𝗶𝗿𝘀𝘁 5 𝗱𝗮𝘆𝘀 𝗮𝗳𝘁𝗲𝗿 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 𝘁𝗼 𝗹𝗶𝗴𝗵𝘁 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆. If your job involves desk work/light activity you can resume work in 4-5 days, but you might experience a slight discomfort. For 1-2 weeks after surgery you are forbidden vigorous exercise – running, heavy lifting, straining, cycling, horseback riding etc.
➡️The scrotal swelling is to be expected and it might last a few weeks to return to normal; you should call your doctor if you experience severe swelling and the sc***um becomes very inflamated. 𝗗𝘂𝗿𝗶𝗻𝗴 𝘁𝗵𝗲 𝗳𝗶𝗿𝘀𝘁 48 𝗵𝗼𝘂𝗿𝘀, 𝘁𝗵𝗲 𝗱𝗼𝗰𝘁𝗼𝗿 𝘄𝗶𝗹𝗹 𝗿𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱 𝗮𝗽𝗽𝗹𝘆𝗶𝗻𝗴 𝗶𝗰𝗲 𝗽𝗮𝗰𝗸𝘀 𝘁𝗼 𝘁𝗵𝗲 𝘀𝗰𝗿𝗼𝘁𝘂𝗺 𝗳𝗼𝗿 15 𝗺𝗶𝗻𝘂𝘁𝗲𝘀 𝗲𝘃𝗲𝗿𝘆 𝗵𝗼𝘂𝗿; it is important to wrap the ice in a cloth or towel, not place it directly on the skin. Also, you should wear tight underwear to support your sc***um and reduce swelling for the week after surgery.

31/07/2021

👉𝗧𝗵𝗲 𝗰𝗵𝗼𝗶𝗰𝗲 𝗼𝗳 𝗺𝗲𝘁𝗵𝗼𝗱 𝗳𝗼𝗿 𝘀𝗽𝗲𝗿𝗺 𝗿𝗲𝘁𝗿𝗶𝗲𝘃𝗮𝗹 𝗶𝘀 𝘁𝗵𝗲 𝗼𝗻𝗲 𝘁𝗵𝗮𝘁 𝗿𝗲𝘁𝗿𝗶𝗲𝘃𝗲𝘀 𝗮𝗻 𝗮𝗱𝗲𝗾𝘂𝗮𝘁𝗲 𝗻𝘂𝗺𝗯𝗲𝗿 𝗼𝗳 𝘀𝗽𝗲𝗿𝗺 𝘄𝗶𝘁𝗵 𝘁𝗵𝗲 𝗹𝗲𝗮𝘀𝘁 𝘁𝗿𝗮𝘂𝗺𝗮 𝘁𝗼 𝘁𝗵𝗲 𝘁𝗲𝘀𝘁𝗲𝘀, 𝗮𝗻𝗱 𝘁𝗵𝗲 𝗹𝗲𝗮𝘀𝘁 𝗱𝗶𝘀𝗰𝗼𝗺𝗳𝗼𝗿𝘁 𝗮𝗻𝗱 𝗲𝘅𝗽𝗲𝗻𝘀𝗲 𝘁𝗼 𝘁𝗵𝗲 𝗽𝗮𝘁𝗶𝗲𝗻𝘁. Hence, the choice of procedure should be customized to the patient, instead of applying one procedure to all cases.

‼️The urologist/surgeon is the only one who can decide the best approach, corroborating the results of the medical exam, the specific tests and investigations, the medical history and, of course, the preferred choice of the patient.

➡️As 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘 𝗶𝘀 𝘁𝗵𝗲 𝗺𝗼𝘀𝘁 𝗲𝗳𝗳𝗶𝗰𝗶𝗲𝗻𝘁 𝗺𝗲𝘁𝗵𝗼𝗱 𝗳𝗼𝗿 𝗿𝗲𝘁𝗿𝗶𝗲𝘃𝗶𝗻𝗴 𝘀𝗽𝗲𝗿𝗺, many surgeons routinely do micro-TESE for all patients clinically suspected to have non-obstructive azoos***mia.

18/07/2021

❓WHY WOULD SURGICAL S***M RECOVERY BE PERFORMED❓

The most common reason is because 𝘀𝗽𝗲𝗿𝗺 𝗮𝗿𝗲 𝗻𝗼𝘁 𝗽𝗿𝗲𝘀𝗲𝗻𝘁 𝗶𝗻 𝘁𝗵𝗲 𝗲𝗷𝗮𝗰𝘂𝗹𝗮𝘁𝗲. This can be because the vas deferens (the tube which carries s***m from the te**is) can be blocked due to a vasectomy or if the man is a carrier of the genes for cystic fibrosis. Sometimes the s***m are present in the te**is in very low quantities and are not seen in the ej*****te.

❓WHO NEEDS MICRO-TESE❓

𝗠𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘 𝗶𝘀 𝗿𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱𝗲𝗱 𝗳𝗼𝗿 𝗽𝗲𝗼𝗽𝗹𝗲 𝘄𝗵𝗼 𝗵𝗮𝘃𝗲 𝗮𝗯𝗻𝗼𝗿𝗺𝗮𝗹 𝘀𝗽𝗲𝗿𝗺 𝗽𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻 (non-obstructive azoos***mia). There are many causes of this including previous testicular surgery, previous medical treatment, a genetic problem, and other male factor infertility issues. Your surgeon will have organised tests to investigate this before surgery.

26/06/2021

👉Micro-TESE is a safe procedure in experienced hands and provides infertile men with NOA an opportunity to father children. However, according to a study published in 2018, 𝘂𝗻𝘀𝗲𝗹𝗲𝗰𝘁𝗲𝗱 𝗰𝗮𝗻𝗱𝗶𝗱𝗮𝘁𝗲𝘀 𝘄𝗶𝘁𝗵 𝗡𝗢𝗔 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗰𝗼𝘂𝗻𝘀𝗲𝗹𝗹𝗲𝗱 𝗮𝘁 𝘁𝗵𝗲 𝗼𝘂𝘁𝘀𝗲𝘁 𝘁𝗵𝗮𝘁 𝗼𝗻𝗹𝘆 17.9% 𝘄𝗶𝗹𝗹 𝗲𝘃𝗲𝗻𝘁𝘂𝗮𝗹𝗹𝘆 𝗯𝗲𝗰𝗼𝗺𝗲 𝗯𝗶𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗳𝗮𝘁𝗵𝗲𝗿𝘀.

➡️The sc***um is one of the fastest healing parts of the body, so 𝗺𝗼𝘀𝘁 𝗺𝗲𝗻 𝗿𝗲𝗰𝗼𝘃𝗲𝗿 𝗾𝘂𝗶𝗰𝗸𝗹𝘆 𝗮𝗻𝗱 𝗵𝗮𝘃𝗲 𝘃𝗲𝗿𝘆 𝗹𝗶𝘁𝘁𝗹𝗲 𝗽𝗮𝗶𝗻 after surgery. But your surgeon urologist will prescribe pain medication just in case.

☑️The multi-layered closure technique used for the procedure helps to ensure that 𝗺𝗲𝗻 𝗱𝗼𝗻'𝘁 𝗵𝗮𝘃𝗲 𝗶𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝗻𝘀 𝗼𝗿 𝗯𝗹𝗲𝗲𝗱𝗶𝗻𝗴 𝗮𝗳𝘁𝗲𝗿 𝘁𝗵𝗲 𝘀𝘂𝗿𝗴𝗲𝗿𝘆.

05/06/2021

❓WHAT MAKES MICROTESE SUCCESSFUL❓

👉For microTESE to be successful, you need to have 𝗮 𝘀𝗸𝗶𝗹𝗹𝗳𝘂𝗹 𝘀𝘂𝗿𝗴𝗲𝗼𝗻 𝗮𝗻𝗱 𝗮𝗻 𝗲𝘅𝗰𝗲𝗹𝗹𝗲𝗻𝘁 𝗮𝗻𝗱𝗿𝗼𝗹𝗼𝗴𝘆 𝘁𝗲𝗰𝗵𝗻𝗼𝗹𝗼𝗴𝗶𝘀𝘁 searching for s***m. During your microTESE procedure, an andrology lab technician will be in the operating room to analyze your seminiferous tubules for s***m.

➡️If the technician finds s***m during your microTESE, your s***m will be extracted and frozen so they can be used in future reproductive treatments, like 𝗶𝗻-𝘃𝗶𝘁𝗿𝗼 𝗳𝗲𝗿𝘁𝗶𝗹𝗶𝘇𝗮𝘁𝗶𝗼𝗻 (𝗜𝗩𝗙) 𝘄𝗶𝘁𝗵 𝗶𝗻𝘁𝗿𝗮𝗰𝘆𝘁𝗼𝗽𝗹𝗮𝘀𝗺𝗶𝗰 𝘀𝗽𝗲𝗿𝗺 𝗶𝗻𝗷𝗲𝗰𝘁𝗶𝗼𝗻 (𝗜𝗖𝗦𝗜).

‼️Current data shows that 𝘁𝗵𝗮𝘁 𝗳𝗿𝗼𝘇𝗲𝗻 𝘀𝗽𝗲𝗿𝗺 𝗺𝗮𝘆 𝗽𝗲𝗿𝗳𝗼𝗿𝗺 𝗲𝘃𝗲𝗻 𝗯𝗲𝘁𝘁𝗲𝗿 𝘁𝗵𝗮𝗻 𝗳𝗿𝗲𝘀𝗵 𝘀𝗽𝗲𝗿𝗺 during IVF (in-vitro fertilization).

22/05/2021

👉Overview of preoperative factors considered for prediction of micro-TESE outcome according to a study published in 2013:

🔹𝗦𝗲𝗿𝘂𝗺 𝗙𝗦𝗛 - FSH, although a good predictor of global testicular function, does not serve by itself as a predictor of successful micro-TESE, but models have shown some predictive value when used in conjunction with other variables
🔹𝗦𝗲𝗿𝘂𝗺 𝗜𝗻𝗵𝗶𝗯𝗶𝗻 𝗕 - Inhibin B, like FSH, does not serve as a good predictor of micro-TESE by itself, but models have shown predictive value when used in conjunction with other variables
🔹𝗛𝗶𝘀𝘁𝗼𝗽𝗮𝘁𝗵𝗼𝗹𝗼𝗴𝘆 - Histopathology is likely the greatest single predictor of successful micro-TESE, but the requirement of a separate surgical procedure for diagnosis makes its role very limited
🔹𝗧𝗲𝘀𝘁𝗶𝗰𝘂𝗹𝗮𝗿 𝘃𝗼𝗹𝘂𝗺𝗲 - The data on testicular volume and its predictive value for micro-TESE is limited, and suggests that it is not a good predictive variable for micro-TESE
🔹𝗚𝗲𝗻𝗲𝘁𝗶𝗰𝘀 - Genetics, particularly Y chromosome microdeletions, are very helpful in predicting success of micro-TESE; men with AZFc microdeletions have very good chance of successful micro-TESE, whereas those men with AZFa or AZFb have a low probability of success
Klinefelter’s Syndrome (KS) - Men with KS have successful micro-TESE rates similar to or better than all men with NOA, and KS itself is a good prognostic factor for s***m retrieval
🔹𝗔𝗴𝗲 - While advanced paternal age may play a role in decreased pregnancy rates, the limited studies thus far show that it does not play a predictive role for micro-TESE
🔹𝗖𝗿𝘆𝗽𝘁𝗼𝗿𝗰𝗵𝗶𝗱𝗶𝘀𝗺 - Men with a history of cryptorchidism have successful micro-TESE rates to men without cryptorchidism, suggesting that it does not play a predictive role in the success of micro-TESE
🔹𝗩𝗮𝗿𝗶𝗰𝗼𝗰𝗲𝗹𝗲 - The need for varicocelectomy in men with a varicocele and NOA prior to micro-TESE is debated, but men with a clinical varicocele who undergo varicocelectomy prior to micro-TESE have higher s***m retrieval rates compared to men with all other causes of NOA, suggesting that varicocele repair is a positive prognostic factor for men undergoing micro-TESE

10/05/2021

ℹ️Several studies in the literature report 𝘀𝘂𝗰𝗰𝗲𝘀𝘀𝗳𝘂𝗹 𝘀𝗽𝗲𝗿𝗺 𝗿𝗲𝗰𝗼𝘃𝗲𝗿𝘆 𝘄𝗶𝘁𝗵 𝘀𝗮𝗹𝘃𝗮𝗴𝗲 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘 𝗮𝗳𝘁𝗲𝗿 𝗳𝗮𝗶𝗹𝗲𝗱 𝗰𝗼𝗻𝘃𝗲𝗻𝘁𝗶𝗼𝗻𝗮𝗹 𝗧𝗘𝗦𝗘.

In this direction study published in July 2020, a retrospective cohort, involved 125 men with a failed previous micro-TESE at health institutions who underwent repeated micro-TESE between November 2014 and July 2018. Clinical parameters of the patients were compared for the success of s***m recovery between the patients who had successful s***m recovery and who did not have.

➡️𝗦𝗽𝗲𝗿𝗺 𝘄𝗮𝘀 𝘀𝘂𝗰𝗰𝗲𝘀𝘀𝗳𝘂𝗹𝗹𝘆 𝗿𝗲𝗰𝗼𝘃𝗲𝗿𝗲𝗱 𝗶𝗻 23 𝗼𝗳 125 (18,4%) 𝗺𝗲𝗻 𝘄𝗶𝘁𝗵 𝗿𝗲𝗽𝗲𝗮𝘁𝗲𝗱 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘.

Repeated micro-TESE achieved s***m retrieval in 18.4% of men with NOA (nonobstructive azoos***mia) who failed the first micro-TESE. This cohort is the largest repeat micro-TESE series in patients with NOA who have a failed initial micro-TESE attempt.

‼️When consulting the patients who had a failed Micro TESE, the results from the current study may enable for them 𝘃𝗮𝗹𝘂𝗮𝗯𝗹𝗲 𝗶𝗻𝗳𝗼𝗿𝗺𝗮𝘁𝗶𝗼𝗻 𝗯𝗲𝗳𝗼𝗿𝗲 𝘁𝗵𝗲 𝗱𝗲𝗰𝗶𝘀𝗶𝗼𝗻 𝘁𝗼 𝗿𝗲𝗽𝗲𝗮𝘁 𝗺𝗶𝗰𝗿𝗼 𝗧𝗘𝗦𝗘.

01/05/2021

Dr.Vakalidis wishes you health and peaceful holidays!

24/04/2021

ℹ️Klinefelter's syndrome is a chromosomal disorder causing testicular failure and azoos***mia (the complete absence of s***m in the ej*****te) in the vast majority of affected men; 𝗶𝘁 𝗮𝗳𝗳𝗲𝗰𝘁𝘀 𝗺𝗮𝗹𝗲𝘀 𝗮𝗻𝗱 𝗶𝘁 𝗿𝗲𝗺𝗮𝗶𝗻𝘀 𝗼𝗳𝘁𝗲𝗻 𝘂𝗻𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗲𝗱 𝘂𝗻𝘁𝗶𝗹 𝗮𝗱𝘂𝗹𝘁𝗵𝗼𝗼𝗱, 𝗰𝗼𝗻𝘀𝗶𝘀𝘁𝗶𝗻𝗴 𝗶𝗻 𝗮𝗻 𝗲𝘅𝘁𝗿𝗮 𝗰𝗼𝗽𝘆 𝗼𝗳 𝘁𝗵𝗲 𝗫 𝗰𝗵𝗿𝗼𝗺𝗼𝘀𝗼𝗺𝗲.

➡️Statistically, men with Klinefelter syndrome are thought to make up 3% 𝗼𝗳 𝗶𝗻𝗳𝗲𝗿𝘁𝗶𝗹𝗲 𝗺𝗲𝗻 𝗮𝗻𝗱 11% 𝗼𝗳 𝗺𝗲𝗻 𝘄𝗶𝘁𝗵 𝗮𝘇𝗼𝗼𝘀𝗽𝗲𝗿𝗺𝗶𝗮 (Foresta et al., 1999). Infertility is caused by degeneration of the germ cells in Klinefelter males but the exact mechanism by which this occurs is not fully understood.

Until 1996, men with Klinefelter syndrome were considered infertile. Since then, however, developments in microsurgical techniques and advances in 𝗮𝗿𝘁𝗶𝗳𝗶𝗰𝗶𝗮𝗹 𝗿𝗲𝗽𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝘃𝗲 𝘁𝗲𝗰𝗵𝗻𝗼𝗹𝗼𝗴𝗶𝗲𝘀 (𝗔𝗥𝗧) 𝗵𝗮𝘃𝗲 𝗲𝗻𝗮𝗯𝗹𝗲𝗱 𝗼𝘃𝗲𝗿 50% 𝗼𝗳 𝗺𝗲𝗻 𝘄𝗶𝘁𝗵 𝗞𝗹𝗶𝗻𝗲𝗳𝗲𝗹𝘁𝗲𝗿 𝘀𝘆𝗻𝗱𝗿𝗼𝗺𝗲 𝘁𝗼 𝘀𝗶𝗿𝗲 𝘁𝗵𝗲𝗶𝗿 𝗼𝘄𝗻 𝗰𝗵𝗶𝗹𝗱𝗿𝗲𝗻. Success has been achieved through a combination of microsurgical testicular s***m extraction (TESE) and the use of freshly retrieved s***m for in-vitro fertilization (IVF).

▶️A study of 42 men with Klinefelter syndrome revealed a 𝗮 𝘀𝗽𝗲𝗿𝗺 𝗿𝗲𝘁𝗿𝗶𝗲𝘃𝗮𝗹 𝗿𝗮𝘁𝗲 𝗼𝗳 72% 𝗽𝗲𝗿 𝘁𝗲𝘀𝘁𝗶𝗰𝘂𝗹𝗮𝗿 𝘀𝗽𝗲𝗿𝗺 𝗲𝘅𝘁𝗿𝗮𝗰𝘁𝗶𝗼𝗻 𝗮𝘁𝘁𝗲𝗺𝗽𝘁, 𝘄𝗶𝘁𝗵 𝗮𝗱𝗲𝗾𝘂𝗮𝘁𝗲 𝘀𝗽𝗲𝗿𝗺 𝗳𝗼𝗿 𝗜𝗖𝗦𝗜 𝗳𝗼𝘂𝗻𝗱 𝗶𝗻 69% 𝗼𝗳 𝘀𝘂𝗯𝗷𝗲𝗰𝘁𝘀 (29 𝗼𝗳 42 𝗺𝗲𝗻). Thus, TESE and ICSI may be considered for males with azoos***mia and Klinefelter syndrome.

10/04/2021

ℹ️𝗠𝗶𝗰𝗿𝗼𝗧𝗘𝗦𝗘 𝘄𝗮𝘀 𝗳𝗶𝗿𝘀𝘁 𝗱𝗲𝘀𝗰𝗿𝗶𝗯𝗲𝗱 𝗶𝗻 1999 𝗮𝗻𝗱 𝗿𝗲𝗽𝗿𝗲𝘀𝗲𝗻𝘁𝘀 𝗮𝗻 𝗲𝘃𝗼𝗹𝘂𝘁𝗶𝗼𝗻 𝗳𝗿𝗼𝗺 𝗰𝗼𝗻𝘃𝗲𝗻𝘁𝗶𝗼𝗻𝗮𝗹 𝗧𝗘𝗦𝗘. With the magnification provided by an operating microscope, Dr. Peter Schlegel was able to observe heterogeneity amongst seminiferous tubules within the testicle and noticed that focal areas of dilated seminiferous tubules were more likely to contain areas of active s***matogenesis.

➡️By identifying and selectively removing only dilated seminiferous tubules, 𝗦𝗥𝗥𝘀 (𝗦𝗽𝗲𝗿𝗺 𝗥𝗲𝘁𝗿𝗶𝗲𝘃𝗮𝗹 𝗥𝗮𝘁𝗲𝘀) 𝗶𝗻𝗰𝗿𝗲𝗮𝘀𝗲𝗱 𝗳𝗿𝗼𝗺 16.7–45% 𝘁𝗼 42.9–63%, with greater numbers of s***m retrieved (160,000 vs. 64,000), and 70-fold less tissue excised (9.4 vs. 720 mg).

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