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Vascularity index of the testis: a guiding technique for testicular sperm extraction (TESE)
Author(s) -
HarToov J.,
Eitan O.,
Hauser R.,
Butchan A.,
Gull I.,
Wolman I.,
Yavez H.,
Jaffa A. J.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.abs26-31.x
Subject(s) - vascularity , medicine , testicular sperm extraction , anatomy , ultrasound , testicular volume , sagittal plane , varicocele , nuclear medicine , radiology , azoospermia , biology , infertility , pregnancy , genetics , hormone , secondary sex characteristic
Aim: To develop a non‐invasive computerized technique that predicts the presence of spermatogenic sites within the testes of non‐obstructive azoospermic (NOA) patients. Material and methods: Power Doppler ultrasound images of the testes of seven NOA patients and six fertile men were acquired. Three sagittal, three transverse and one coronal cross‐sections of the testis were scanned by a linear 7.5 MHz transducer. Three‐dimensional (3D) matrix of 32 elements was generated from all images of each testis. Each element carried information (a vascularity index, VI) about the blood vessels that crossed its volume. The matrix (4 × 4 × 2) was divided into regions of 16 elements which were classified as ‘positive’, ‘negative’ and ‘undetermined’ according to the VI values in the anterior and posterior layers of a region. The NOA patients underwent testicular biopsies at three locations along the midline of the testis. The results of the biopsies were correlated to the appropriate regions in the 3D matrix. Results: Of the seven NOA patients, 12 testes were scanned, however, only 27 biopsies were performed. Accordingly, only 27 regions were considered. Thirteen regions were ‘positive’, 12 regions were ‘negative’, and two were ‘undetermined’. Motile spermatozoa were found in nine out of 12 ‘positive’ regions (69.2%). No sperm was found in 10 of the 12 ‘negative’ region (83.3%). In the control group of six patients, there were 12 testes, which divided into 36 regions. Twenty‐four regions were ‘negative’ (66.7%), one was ‘positive’ (2.7%) and 11 were ‘undetermined’ (30.6%). Conclusion: The results yielded that positive/negative region predict the presence or absence of spermatozoa, and thus, this method appears to be a promising non‐invasive guiding tool for TESE in NOA patients. TESE will be more effective, less biopsies will be needed, and testicular damage will significantly be lowered. However, this method is not suitable to identify spermatozoa in fertile men.