Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review

Testicular tumor is the most common solid malignancy in males under 40 years of age. This malignancy is known to have a negative impact on male fertility. Therefore, several techniques for sperm retrieval have been proposed, including microdissection testicular sperm extraction (mTESE). The objectiv...

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Main Authors: Carlo Giulioni, Nguyen Ho Vinh Phuoc, Selahittin Cayan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Asian Journal of Andrology
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Online Access:https://journals.lww.com/10.4103/aja202387
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author Carlo Giulioni
Nguyen Ho Vinh Phuoc
Selahittin Cayan
author_facet Carlo Giulioni
Nguyen Ho Vinh Phuoc
Selahittin Cayan
author_sort Carlo Giulioni
collection DOAJ
description Testicular tumor is the most common solid malignancy in males under 40 years of age. This malignancy is known to have a negative impact on male fertility. Therefore, several techniques for sperm retrieval have been proposed, including microdissection testicular sperm extraction (mTESE). The objective of this study was to review the literature on the outcomes of oncological (Onco)-mTESE at the time of radical orchiectomy. We conducted a comprehensive literature search through PubMed, Scopus, and Cochrane Central Controlled Register of Trials. Only studies reporting ex vivo mTESE in patients with testicular tumor were considered. Twelve papers met the inclusion criteria and were included in this review. Tumor size was identified as the sole preoperative factor influencing spermatogenesis. The considered studies demonstrated a satisfactory success rate for Onco-mTESE, associated with a similarly valid percentage of live healthy births through assisted reproductive technology. Currently, no comparison has been made between Onco-mTESE and conventional Onco-TESE, hence further assessment is required. In cases where the tumor completely replaces the cancer-bearing testicle, a contralateral micro-TESE may be a viable alternative. However, the surgeon should evaluate associated risks and benefits preoperatively. In conclusion, Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors. Nevertheless, additional studies are necessary to achieve a definitive conclusion.
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spelling doaj-art-c48dbc5bd55f4963b3444719a4adbc1c2025-08-20T03:19:53ZengWolters Kluwer Medknow PublicationsAsian Journal of Andrology1008-682X1745-72622025-05-0127341642210.4103/aja202387Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping reviewCarlo GiulioniNguyen Ho Vinh PhuocSelahittin CayanTesticular tumor is the most common solid malignancy in males under 40 years of age. This malignancy is known to have a negative impact on male fertility. Therefore, several techniques for sperm retrieval have been proposed, including microdissection testicular sperm extraction (mTESE). The objective of this study was to review the literature on the outcomes of oncological (Onco)-mTESE at the time of radical orchiectomy. We conducted a comprehensive literature search through PubMed, Scopus, and Cochrane Central Controlled Register of Trials. Only studies reporting ex vivo mTESE in patients with testicular tumor were considered. Twelve papers met the inclusion criteria and were included in this review. Tumor size was identified as the sole preoperative factor influencing spermatogenesis. The considered studies demonstrated a satisfactory success rate for Onco-mTESE, associated with a similarly valid percentage of live healthy births through assisted reproductive technology. Currently, no comparison has been made between Onco-mTESE and conventional Onco-TESE, hence further assessment is required. In cases where the tumor completely replaces the cancer-bearing testicle, a contralateral micro-TESE may be a viable alternative. However, the surgeon should evaluate associated risks and benefits preoperatively. In conclusion, Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors. Nevertheless, additional studies are necessary to achieve a definitive conclusion.https://journals.lww.com/10.4103/aja202387assisted reproductive technologyex vivomicrodissection testicular sperm extractionradical orchiectomytesticular tumor
spellingShingle Carlo Giulioni
Nguyen Ho Vinh Phuoc
Selahittin Cayan
Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review
Asian Journal of Andrology
assisted reproductive technology
ex vivo
microdissection testicular sperm extraction
radical orchiectomy
testicular tumor
title Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review
title_full Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review
title_fullStr Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review
title_full_unstemmed Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review
title_short Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review
title_sort ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia noa a scoping review
topic assisted reproductive technology
ex vivo
microdissection testicular sperm extraction
radical orchiectomy
testicular tumor
url https://journals.lww.com/10.4103/aja202387
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AT selahittincayan exvivomicroscopictesticularspermextractionatthetimeofradicalorchiectomyinmenwithnonobstructiveazoospermianoaascopingreview