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• W2795523114 abstract "You have accessJournal of UrologyInfertility: Therapy I1 Apr 2018PD01-09 EFFECTS OF PREOPERATIVE MEDICAL TREATMENT ON SPERM RETRIEVAL RATES IN PRIMARY AND RECURRENT MICRO TESE Murad Basar, Yesim Kumtepe-Colakoglu, Hakan Yelke, Serkan Selimoglu, Mirac Turan, and Semra Kahraman Murad BasarMurad Basar More articles by this author , Yesim Kumtepe-ColakogluYesim Kumtepe-Colakoglu More articles by this author , Hakan YelkeHakan Yelke More articles by this author , Serkan SelimogluSerkan Selimoglu More articles by this author , Mirac TuranMirac Turan More articles by this author , and Semra KahramanSemra Kahraman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.222AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The aim of the present study was to evaluate the effect of preoperative medical treatment on sperm retrieval rates in primary and recurrent micro TESE cases. METHODS A number of 894 non-obstructive azoospermia (NOA) male patients of primary and recurrent micro TESE for NOA were included in the study between October 2011 and September 2017.397 (44.4%) of the cases were primary and the remaining 497 (55.6%) were secondary. The number of previously applied micro TESE cases ranged from 1 to 7 and while any spermatozoa was not found in 253 (50.9%), spermatozoa was found in the remaining 244 cases (49.1%). Serum hormone levels including FSH, total testosterone and estradiol levels were measured through a detailed urologic examination and genetic tests including peripheric karyotype and Y micro deletions were performed on all cases. Although all the cases had semen analysis which was applied in an outer center, the existence of non-obstructive azoospermia was confirmed in the hospital laboratory by a new semen analysis. Seminal channels were evaluated with TRUS, if it was necessary. The patients were randomized into two groups and 5.000-10.000 unit of hCG was given to 535 patients (59.8%) in group-1 weekly according to serum testosterone level. Serum hormone levels were checked at the 6th weeks of the treatment. The treatment continued for another four week through adding aromatase inhibitor if there was no increase in testosterone level or TT/E2 ratio less than 0.10. For other cases, only hCG therapy was continued for four more weeks. After a total of 10 weeks of treatment, serum hormone levels were measured again. If FSH level was suppressed, 150-225 units of hMG were added per week and combined treatment was continued for 3 months. In non-suppressed FSH cases, hCG therapy was continued and hormone levels were checked at 6-week intervals. Medical treatment was carried on for 7-8 months in both groups and micro TESE was applied at the end of that period. Serum hormone levels were reevaluated just before micro TESE operation. Total sperm retrieval rates in treated and untreated groups and in accordance with the medical treatment in primary and recurrent micro TESE were assessed separately. RESULTS While the sperm retrieval rate was 56.4% (302/535) in treated cases, this rate realized as 46.5% (167/359) in untreated cases. A statistically significant difference was observed between two groups (Pearson ?2=8.495, p=0.002). When the same parameters were evaluated after dividing into two groups as primary and recurrent micro TESE, there was a statistical dissimilarity between testis volume (p=0.001) and serum testosterone levels (p=0.001) in primary cases. On the contrary, serum sex steroid levels as well as demographic parameters were significantly different in recurrent micro TESE cases (p<0.005). Sperm retrieval rate was 51.1% (203/397) in primary cases and 50.1% (249/497) in recurrent cases. When primary and recurrent cases were evaluated according to treatment groups, medical treatment was performed on 196 (49.4%) patients in primary cases, while treatment was not applied to 201 (50.6%) patients. In primary group, sperm retrieval rate in the treated and untreated cases was 50.2% and 52%, respectively. There was no significant difference between the groups (Pearson ?2=0.095, p=0.418). In the recurrent micro TESE group, while medical treatment was applied to 340 patients (68.4%), 157 patients (31.6%) were not treated. In these cases, sperm retrieval rate in the treated and untreated groups was 43.2% and 65%, respectively. There was a statistically significant difference between the two groups (Pearson ?2=20.292, p=0.001). CONCLUSIONS We concluded that the effect of medical treatment on sperm retrieval rate is not clear in primary and recurrent micro TESE cases. As a main result, the underlying etiopathologic factor and previous micro TESE outcome in recurrent cases are the main determinant factor. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e63 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Murad Basar More articles by this author Yesim Kumtepe-Colakoglu More articles by this author Hakan Yelke More articles by this author Serkan Selimoglu More articles by this author Mirac Turan More articles by this author Semra Kahraman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2795523114 title "PD01-09 EFFECTS OF PREOPERATIVE MEDICAL TREATMENT ON SPERM RETRIEVAL RATES IN PRIMARY AND RECURRENT MICRO TESE" @default.
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