Y.M. was one of our non-obstructive azoospermic patients. During his first TESE attempt in another center no mature sperm cell was found. His recent hormone measurements were FSH 3 mIU/ml, total testosterone 144 ng/dl and E2 19 pg/ml.
According to these results tamoxifen and human chorionic gonadotrophin (hCG) treatment were initiated. The hormone measurements were regularly checked and the dosages were adjusted accordingly. After 6 months PCNA, LIM15, ESX and TEX101 expressions were determined in seminal plasma and all were found higher than reference level. Although no mature spermatozoon was found in ejaculate, flow cytometric analysis identified that 15% of the round cells were in haploid character.
Then, second microTESE was planned and performed bilaterally. Few motile spermatozoa with completed tail formation were successfully retrieved and cryopreserved. Subsequent ICSI established a single healthy pregnancy.
Regarding also our previous results, we believe that hCG-based hormonal therapy has an important role for stimulating spermatogenesis and successful sperm retrieval in repeated TESE cases. But such a treatment protocol requires proper dose adjustment and timing of hCG treatment under the strict hormonal follow up. Beside this, marker measurements have a significant effect on the decision of TESE.
You can send your questions to
Prof.Dr. Kaan Aydos
Mahatma Gandhi Caddesi, 19/7 06700 Cankaya, Ankara / TURKEY
+90 312 437 3121 +90 312 508 2258