OBJECTIVES: Microdissection testicular sperm extraction (micro-TESE) has been performed at some experienced male infertility centers. Micro-TESE in patients with nonobstructive azoospermia (NOA) has been shown to be not only feasible and safe but also a technically demanding operation. To evaluate whether the improvement of surgical outcomes of micro-TESE, we hereby report the learning curves of micro-TESE for NOA patients. DESIGN: Retrospective clinical analysis. SETTING: Male infertility center. PATIENT(S): Since 2006, micro-TESE was performed in 150 patients with NOA by a single surgeon. INTERVENTION(S): After the tunica albuginea was opened, direct examination of the testicular parenchyma was performed at x25 magnification. MAIN OUTCOME MEASURE(S): Sperm retrieval rate and clinical factors in the first 50 patients (group A), the middle 50 patients (group B), and the last 50 patients (group C) were examined. RESULT(S): There were no differences in clinical factors among the three groups. Total operation times were shorter in group B and C than in group A (P<0.05). The sperm retrieval rate in group B (44%) and C (48%) was significantly higher than in group A (32%; P<0.05). CONCLUSION(S): As cases increase, surgical outcomes and sperm retrieval rate have improved. We think that this report showed substantial learning curves for a microscopic surgery such as micro-TESE. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
OBJECTIVES: Microdissection testicular sperm extraction (micro-TESE) has been performed at some experienced male infertility centers. Micro-TESE in patients with nonobstructive azoospermia (NOA) has been shown to be not only feasible and safe but also a technically demanding operation. To evaluate whether the improvement of surgical outcomes of micro-TESE, we hereby report the learning curves of micro-TESE for NOA patients. DESIGN: Retrospective clinical analysis. SETTING:Male infertility center. PATIENT(S): Since 2006, micro-TESE was performed in 150 patients with NOA by a single surgeon. INTERVENTION(S): After the tunica albuginea was opened, direct examination of the testicular parenchyma was performed at x25 magnification. MAIN OUTCOME MEASURE(S): Sperm retrieval rate and clinical factors in the first 50 patients (group A), the middle 50 patients (group B), and the last 50 patients (group C) were examined. RESULT(S): There were no differences in clinical factors among the three groups. Total operation times were shorter in group B and C than in group A (P<0.05). The sperm retrieval rate in group B (44%) and C (48%) was significantly higher than in group A (32%; P<0.05). CONCLUSION(S): As cases increase, surgical outcomes and sperm retrieval rate have improved. We think that this report showed substantial learning curves for a microscopic surgery such as micro-TESE. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.