Microdissection testicular sperm extraction (microTESE) vs testicular sperm extraction (TESE)

Microdissection testicular sperm extraction (microTESE) and testicular sperm extraction (TESE) are both surgical procedures used to retrieve sperm from the testicles in men with nonobstructive azoospermia, a condition where sperm is absent in the ejaculate due to testicular dysfunction.
TESE, also known as conventional or blind testicular biopsy, involves taking small tissue samples from the testicles and examining them under a microscope to identify and extract viable sperm. This method involves randomly sampling different areas of the testicle, which may include healthy and non-functioning areas, leading to lower success rates in sperm retrieval.

On the other hand, microTESE is a more advanced technique that utilizes an operating microscope to visualize and selectively target areas of the testicles that are more likely to contain sperm. It involves the identification and extraction of seminiferous tubules, which are responsible for sperm production. By specifically targeting these tubules, microTESE aims to improve the chances of finding viable sperm while minimizing damage to the surrounding tissue.

Compared to conventional TESE, microTESE has demonstrated higher success rates in sperm retrieval, with studies reporting retrieval rates of around 50-60% or even higher in some cases. The improved precision and selectivity of microTESE contribute to its increased efficacy in finding viable sperm, making it a preferred option for men with nonobstructive azoospermia.

Here are a few references related to microTESE and TESE:

1. Schlegel PN, et al. (2002). Microdissection testicular sperm extraction: an update. J Urol. 167(3): 1192-1196. doi: 10.1016/S0022-5347(01)69004-X.
2. Schlegel PN. (1999). Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod. 14(1): 131-135. doi: 10.1093/humrep/14.1.131.
3. Tsujimura A, et al. (2005). Microdissection testicular sperm extraction: prediction, outcome, and complications. Int J Urol. 12(1): 47-53. doi: 10.1111/j.1442-2042.2004.00974.x.
4. Abdel Raheem A, et al. (2013). Microdissection testicular sperm extraction: a comparative study between single-armed and double-armed techniques. J Urol. 189(6): 2320-2324. doi: 10.1016/j.juro.2012.12.052.