Predictors of successful salvage microdissection testicular sperm extraction (mTESE) after failed initial TESE in patients with non-obstructive azoospermia: A systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان:	Predictors of successful salvage microdissection testicular sperm extraction (mTESE) after failed initial TESE in patients with non-obstructive azoospermia: A systematic review and meta-analysis.
المؤلفون:	Zhang F; Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China., Dai M; Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China., Yang X; Department of Nursing, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin, China., Cheng Y; College of Pharmacy, Tianjin Medical University, Tianjin, China., Ye L; Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China., Huang W; Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen, China., Chen X; Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China., Yin T; Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, China., Sha Y; Department of Andrology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.; Fujian Provincial Key Laboratory of Reproductive Health Research, School of Medicine, Xiamen University, Xiamen, China.; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
المصدر:	Andrology [Andrology] 2024 Jan; Vol. 12 (1), pp. 30-44. Date of Electronic Publication: 2023 May 22.
نوع المنشور:	Meta-Analysis; Systematic Review; Journal Article; Review
اللغة:	English
بيانات الدورية:	Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101585129 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-2927 (Electronic) Linking ISSN: 20472919 NLM ISO Abbreviation: Andrology Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Oxford : Wiley-Blackwell, 2013-
مواضيع طبية MeSH:	Azoospermia/surgery , Azoospermia/pathology , Oligospermia/pathology , Sertoli Cell-Only Syndrome, Humans ; Male ; Retrospective Studies ; Microdissection/methods ; Sperm Retrieval ; Semen ; Testis/surgery ; Testis/pathology ; Spermatozoa/pathology ; Follicle Stimulating Hormone ; Luteinizing Hormone ; Follicle Stimulating Hormone, Human
مستخلص:	Background: There has been no systematic review and meta-analysis to analyze and summarize the predictive factors of successful sperm extraction in salvage microdissection testicular sperm extraction. Objectives: We aimed to investigate the factors predicting the result of salvage microdissection testicular sperm extraction in patients with non-obstructive azoospermia who failed the initial microdissection testicular sperm extraction or conventional testicular sperm extraction. Materials and Methods: We conducted a systematic literature search in PubMed, Web of Science, EMBASE, and the Cochrane Library for literature that described the characteristics of patients with non-obstructive azoospermia who underwent salvage microdissection testicular sperm extraction after failing the initial microdissection testicular sperm extraction or conventional testicular sperm extraction published prior to June 2022. Results: This meta-analysis included four retrospective studies with 332 patients with non-obstructive azoospermia who underwent a failed initial microdissection testicular sperm extraction and three retrospective studies with 177 non-obstructive azoospermia patients who underwent a failed conventional testicular sperm extraction. The results were as follows: among non-obstructive azoospermia patients whose first surgery was microdissection testicular sperm extraction, younger patients (standard mean difference: -0.28, 95% confidence interval [CI]: -0.55 to -0.01) and those with smaller bilateral testicular volume (standard mean difference: -0.55, 95% CI: -0.95 to -0.15), lower levels of follicle-stimulating hormone (standard mean difference: -0.86, 95% CI: -1.18 to -0.54) and luteinizing hormone (standard mean difference: -0.68, 95% CI: -1.16 to -0.19), and whose testicular histological type was hypospermatogenesis (odds ratio: 3.52, 95% CI: 1.30-9.53) were more likely to retrieve spermatozoa successfully, while patients with Sertoli-cell-only syndrome (odds ratio: 0.41, 95% CI: 0.24-0.73) were more likely to fail again in salvage microdissection testicular sperm extraction. Additionally, in patients who underwent salvage microdissection testicular sperm extraction after a failed initial conventional testicular sperm extraction, those with testicular histological type of hypospermatogenesis (odds ratio: 30.35, 95% CI: 8.27-111.34) were more likely to be successful, while those with maturation arrest (odds ratio: 0.39, 95% CI: 0.18-0.83) rarely benefited. Conclusion: We found that age, testicular volume, follicle-stimulating hormone, luteinizing hormone, hypospermatogenesis, Sertoli-cell-only syndrome, and maturation arrest were valuable predictors of salvage microdissection testicular sperm extraction, which will assist andrologists in clinical decision-making and minimize unnecessary injury to patients. (© 2023 American Society of Andrology and European Academy of Andrology.)
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معلومات مُعتمدة:	82271672 National Natural Science Foundation of China; 82071697 National Natural Science Foundation of China; 81871200 National Natural Science Foundation of China; 2022BCA042 Key Research and Development Program of Hubei Province; 2020CXB051 Medical Innovation Project of Fujian Province
فهرسة مساهمة:	Keywords: meta-analysis; non-obstructive azoospermia; salvage microdissection testicular sperm extraction; testicular sperm retrieval
المشرفين على المادة:	9002-68-0 (Follicle Stimulating Hormone) 9002-67-9 (Luteinizing Hormone) 0 (Follicle Stimulating Hormone, Human)
تواريخ الأحداث:	Date Created: 20230512 Date Completed: 20231221 Latest Revision: 20231221
رمز التحديث:	20231221
DOI:	10.1111/andr.13448
PMID:	37172416
قاعدة البيانات:	MEDLINE

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تدمد:	2047-2927
DOI:	10.1111/andr.13448