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Testicular sperm extraction in patients with persistent azoospermia after chemotherapy for testicular germ cell tumor
Author(s) -
Sakamoto Hideo,
Oohta Michiya,
Inoue Katuki,
Fuji Khozo,
Fukagai Takashi,
Yoshida Hideki
Publication year - 2007
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2006.01645.x
Subject(s) - azoospermia , testicular sperm extraction , medicine , etoposide , chemotherapy , bleomycin , intracytoplasmic sperm injection , sperm , sperm bank , sperm retrieval , seminoma , andrology , urology , infertility , pregnancy , fertility , biology , population , genetics , environmental health
Sperm cryopreservation before chemotherapy in young males is recommended because of chemotherapy’s gonadotoxic effects. However, many patients miss sperm banking, and consequently are often sterile. Two azoospermic patients presented to us after chemotherapy, and we obtained sperm from them by testicular sperm extraction (TESE). One patient was 32 years old and had been treated with six cycles of cisplatin, etoposide and bleomycin (BEP) chemotherapy and one cycle of high‐dose chemotherapy for stage III non‐seminoma. Histopathology of the testicular specimen showed germinal aplasia with focal islands of full spermatogenesis. Although two intracytoplasmic sperm injection (ICSI) cycles were performed, pregnancy was not achieved. The other patient was 33 years old who was treated with four cycles of BEP chemotherapy for stage II seminoma. Histopathology of the testicular specimen showed Sertoli‐cell‐only syndrome. Ongoing pregnancy was achieved after one ICSI cycle. TESE should be considered in patients with persistent azoospermia after chemotherapy if frozen sperm samples are not available.