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Endocrine Antisperm
disorders antibody
>20% 8-19%
Changes
• Refraining from excessive alcohol intake.
• Avoidance of activity/clothing which may elevate scrotal temperature.
• May result from prior toxic exposures (i.e. chemotherapy, radiation), genetic
abnormality, cryptorchidism, or varicoceles.
“The rates of fertilization and pregnancy were 56% and 39% in the 66 PESA-ICSI
cycles, respectively, and 47% and 45% in the 40 MESA-ICSI cycles. No significant
differences were found in fertilization rates or pregnancy rates among the various
sperm retrieval methods and obstruction etiologies.”
Overall sperm retrieval rate (SRR) ranged from 16.7-45% in the conventional TESE vs 42.9-63% in the mTESE.
Deruyver Y et al., Andrology 2013
Result of a Meta-Analysis on the Outcome of
mTESE Compared with Conventional TESE
• Retroperitoneal (high) ligation of the testicular artery and vein above the
internal inguinal ring (Palomo technique).
• High ligation of the vein while sparing the artery (Bernardi technique).
• Ligation of the cremasteric and internal spermatic veins within the inguinal
canal (Ivanissevich technique).
• Inguinal microsurgical technique.
• Subinguinal microsurgical technique.
• Laparoscopic high ligation.
• Ante/retrograde sclerotherapy.