ONCO-TESE: Obtaining spermatozoa after radical orchiectomy for testicular tumour and azoospermia. 2016

S Luján, and D Guzman-Ordaz, and R Rogel, and E Broseta, and A Pellicer, and F Boronat
Servicio de Urología, Hospital Universitari i Politecnic La Fe, Valencia, España; Instituto Valenciano de Infertilidad, Valencia, España. Electronic address: satlujan@gmail.com.

OBJECTIVE There is the possibility of diagnosing azoospermia in cases of testicular tumours in patients who wish to preserve fertility. Our objective is to present a technique for obtaining spermatozoa from testicles with ex vivo tumours in order to preserve fertility in these patients. METHODS A 34-year-old patient was referred for azoospermia. The physical examination revealed a node in the lower pole of the left testicle. In the scrotal ultrasound, the testicle presented disperse microcalcifications and a 1-cm hypoechoic mass in the lower pole. The tumour markers were negative, and the CT showed no distant disease. Left radical orchiectomy was performed, along with the placement of a testis prosthesis. Bench surgery was then performed, with extraction of the seminiferous tubules in the upper pole. RESULTS Of the submitted samples, 4 progressive and 1 nonprogressive motile spermatozoa were identified per field. Two samples were cryopreserved. The pathological report indicated the presence of a seminoma measuring 1.3 × 1 cm, with free margins and with no invasion of the rete testis (stage I). An assisted reproduction technique (intracytoplasmic sperm injection) was performed on the patient's partner with the frozen spermatozoa, which resulted in pregnancy and the subsequent birth of a healthy child. CONCLUSIONS We propose this technique as the method of choice for obtaining spermatozoa from patients who simultaneously present azoospermia and testicular tumours and who wish to preserve their fertility.

UI MeSH Term Description Entries
D008297 Male Males
D009919 Orchiectomy The surgical removal of one or both testicles. Castration, Male,Orchidectomy,Castrations, Male,Male Castration,Male Castrations,Orchidectomies,Orchiectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013736 Testicular Neoplasms Tumors or cancer of the TESTIS. Germ cell tumors (GERMINOMA) of the testis constitute 95% of all testicular neoplasms. Cancer of Testis,Cancer of the Testes,Testicular Cancer,Testicular Neoplasm,Testicular Tumor,Testis Cancer,Cancer of the Testis,Neoplasms, Testicular,Neoplasms, Testis,Testicular Tumors,Testis Neoplasms,Tumor of Rete Testis,Cancer, Testicular,Cancer, Testis,Cancers, Testicular,Cancers, Testis,Neoplasm, Testicular,Neoplasm, Testis,Rete Testis Tumor,Rete Testis Tumors,Testicular Cancers,Testis Cancers,Testis Neoplasm,Testis Tumor, Rete,Testis Tumors, Rete,Tumor, Testicular,Tumors, Testicular
D053625 Sperm Retrieval Procedures to obtain viable sperm from the male reproductive tract, including the TESTES, the EPIDIDYMIS, or the VAS DEFERENS. Epididymal Sperm Aspiration,Epididymal Sperm Retrieval,Sperm Aspiration,Testicular Sperm Aspiration,Testicular Sperm Retrieval,Vasal Sperm Aspiration,Vasal Sperm Retrieval,Sperm Aspiration, Epididymal,Sperm Aspiration, Testicular,Sperm Aspiration, Vasal,Sperm Retrieval, Epididymal,Sperm Retrieval, Testicular,Sperm Retrieval, Vasal,Sperm Retrievals
D053713 Azoospermia A condition of having no sperm present in the ejaculate (SEMEN).

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