Re: Comparison of Microdissection Testicular Sperm Extraction, Conventional Testicular Sperm Extraction, and Testicular Sperm Aspiration for Nonobstructive Azoospermia: A Systematic Review and Meta-Analysis

In contemporary medicine, testicular sperm extraction (TESE) and using testicular sperm for intracytoplasmic injection is the only fertility treatment in men with nonobstructive azoospermia (NOA). Different sperm retrieval techniques have been used to find a single sperm from the testes of men with NOA. In this study, three sperm retrieval techniques, microdissection TESE (micro TESE), conventional TESE (cTESE), and testicular sperm aspiration (TESA) were compared for yielding successful sperm recovery. Fifteen studies with total of 1890 patients were eligible for inclusion of meta-analysis. These studies were published between 1997 and 2012 and took places - six in Asia, four in Europe, three in North America and two in Africa. Using different tissue processing techniques and the patient heterogeneity that exists in the population of men diagnosed with NOA are the limitations of this study. In conclusion, meta-analysis of the studies has shown that performance of micro-TESE was higher compared with cTESE and performance of cTESE was higher compared with TESA for successful sperm retrieval