Sonographic evidence of minimal and short-term testicular damage after testicular sperm aspiration procedures.

OBJECTIVE: To evaluate ultrasonically the incidence and duration of tissue damage after testicular sperm aspiration (TESA) procedures. DESIGN: Prospective, nonrandomized study. SETTING: Assisted reproductive technology program. PATIENT(S): Thirty-two men with obstructive azoospermia. INTERVENTION(S): Physical and serial testicular ultrasound examinations 1.5, 3, and 6 months after the surgical procedure. MAIN OUTCOME MEASURE(S): Systematic evaluation of the testicular parenchyma and blood flow. RESULT(S): In 93.7% of the patients (30 of 32), no evidence of parenchymal or vascular injuries was found 6 weeks after the procedure. In the remaining 2 patients, transient evidence of tissue damage disappeared after 3 months. CONCLUSION(S): Testicular sperm aspiration is a safe surgical method for sperm retrieval for IVF. Repeated surgical attempts might be considered within 2 months, provided there is no evidence for tissue damage on sonography.

Prognostic value of the clinical and laboratory evaluation in patients with nonmosaic Klinefelter syndrome who are receiving assisted reproductive therapy.

OBJECTIVE: To characterize clinical and laboratory findings in nonmosaic 47,XXY patients that may help to predict spermatogenetic activity in their testicles. DESIGN: Prospective study. SETTING: Assisted reproductive technology program. PATIENT(S): Twenty patients with nonmosaic Klinefelter syndrome who underwent testicular sperm retrieval for IVF. MAIN OUTCOME MEASURE(S): The correlation between basal FSH, LH and testosterone levels, mean testicular volume, and results of the hCG test and presence or absence of sperm after testicular sperm extraction (TESE). RESULT(S): Sperm was found in nine patients (45%). The mean testicular volume was 7.8 +/- 2.5 mL in men with sperm after TESE and 5.6 +/- 1.2 mL in those without sperm after TESE; corresponding testosterone levels were 3.5 +/- 1.2 ng/mL and 1.7 +/- 0.8 ng/mL. Serum levels of FSH and LH did not significantly differ between groups. After the hCG test, the mean serum testosterone level was 16.0 +/- 6.3 ng/mL in men with sperm after TESE and 6.7 +/- 5.6 ng/mL in those without sperm. CONCLUSION(S): Testicular volume, testosterone levels, and results of the hCG test are important predictive factors of spermatogenesis in patients with nonmosaic Klinefelter syndrome.