Factors determining the sperm retrieval rate in fresh versus salvage micro-TESE: a comparative cohort study

  • Medhat Kamel Amer
  • Ahmed Ragab Ahmed
  • Asmaa Ahmed Abdel Hamid
  • Sameh Fayek GamalEl DinEmail author
Urology - Original Paper



We studied prospectively the role of FSH, testis volume, age, duration of infertility, hormonal therapy, varicocelectomy and testicular histopathology in determining the sperm retrieval rate (SRR) in fresh versus salvage micro-TESE.


Our study analysed retrospectively the prospectively maintained database of 330 NOA patients who underwent micro-TESE either 1st or 2nd or 3rd timers from January 2017 to August 2018 from the Andrology Clinic of a specialized IVF centre. They were divided equally into 3 groups, group (1) were 1st timers, group (2) were 2nd timers and group (3) were 3rd timers, respectively.


Interestingly, our study demonstrated a positive correlation between high FSH level and favourable micro-TESE outcome in 1st timers who underwent micro-TESE (p 0.015). Additionally, our study revealed a positive correlation between age and favourable micro-TESE outcome in 2nd timers who underwent micro-TESE (p 0.031). Further, our study revealed a positive correlation between right testicular volume and favourable micro-TESE outcome in 1st timers who underwent micro-TESE (p 0.023). Eventually, there was a significant positive correlation between histopathology which was mainly sertoli cell only syndrome and favourable micro-TESE outcome in 1st timers micro-TESE (p 0.001).


Our study demonstrates that sperms can be retrieved despite high FSH level, and preoperative histopathology is not essential in predicting SRR in NOA patients. Further, age can be considered a good prognostic factor in patients who undergo salvage micro-TESE for the 2nd time.


Non-obstructive azoospermia Fresh micro-TESE Salvage micro-TESE Non-surgical parameters (FSH, testis volume, age, duration of infertility, hormonal therapy) Surgical parameters (varicocelectomy, testicular histopathology) Sperm retrieval hope 



This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethical committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Medhat Kamel Amer
    • 1
    • 2
  • Ahmed Ragab Ahmed
    • 3
  • Asmaa Ahmed Abdel Hamid
    • 4
  • Sameh Fayek GamalEl Din
    • 1
    Email author
  1. 1.Department of Andrology & STDs, Kasr AlAiny Faculty of medicineCairo UniversityGizaEgypt
  2. 2.Adam International HospitalGizaEgypt
  3. 3.Department of Andrology & STDs, Faculty of MedicineBeni-Suef UniversityBeni SuefEgypt
  4. 4.Ministry of Health and populationCairoEgypt

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