Medical treatment prior to micro-TESE

Except in cases of hypogonadotropic hypogonadism, the use of medical therapy before microsurgical testicular sperm extraction (micro-TESE) is controversial. In some studies, hormone therapy has been shown to improve the possibility of sperm retrieval during micro-TESE and even lead to the presence o...

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Main Authors: Sujoy Dasgupta, Thanh Sang Le, Amarnath Rambhatla, Rupin Shah, Ashok Agarwal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Asian Journal of Andrology
Subjects:
Online Access:https://journals.lww.com/10.4103/aja202492
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author Sujoy Dasgupta
Thanh Sang Le
Amarnath Rambhatla
Rupin Shah
Ashok Agarwal
author_facet Sujoy Dasgupta
Thanh Sang Le
Amarnath Rambhatla
Rupin Shah
Ashok Agarwal
author_sort Sujoy Dasgupta
collection DOAJ
description Except in cases of hypogonadotropic hypogonadism, the use of medical therapy before microsurgical testicular sperm extraction (micro-TESE) is controversial. In some studies, hormone therapy has been shown to improve the possibility of sperm retrieval during micro-TESE and even lead to the presence of sperm in the ejaculate in some cases, thereby obviating the need for micro-TESE. However, their routine use before micro-TESE in cases of nonobstructive azoospermia (NOA) being associated with hypergonadotropic hypogonadism and eugonadism (normogonadotropic condition) has not been supported with robust evidence. In this review, we discuss different types of medical therapy used before micro-TESE for NOA, their risks and benefits, and the available evidence surrounding their use in this setting.
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publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-a1a345e7f1a24c13b092a4a2d2067d062025-08-20T03:19:59ZengWolters Kluwer Medknow PublicationsAsian Journal of Andrology1008-682X1745-72622025-05-0127334235410.4103/aja202492Medical treatment prior to micro-TESESujoy DasguptaThanh Sang LeAmarnath RambhatlaRupin ShahAshok AgarwalExcept in cases of hypogonadotropic hypogonadism, the use of medical therapy before microsurgical testicular sperm extraction (micro-TESE) is controversial. In some studies, hormone therapy has been shown to improve the possibility of sperm retrieval during micro-TESE and even lead to the presence of sperm in the ejaculate in some cases, thereby obviating the need for micro-TESE. However, their routine use before micro-TESE in cases of nonobstructive azoospermia (NOA) being associated with hypergonadotropic hypogonadism and eugonadism (normogonadotropic condition) has not been supported with robust evidence. In this review, we discuss different types of medical therapy used before micro-TESE for NOA, their risks and benefits, and the available evidence surrounding their use in this setting.https://journals.lww.com/10.4103/aja202492aromatase inhibitorsgonadotropinsmale infertilitymicrosurgical testicular sperm extractionnonobstructive azoospermiaselective estrogen receptor modulatorssuccessful sperm retrieval
spellingShingle Sujoy Dasgupta
Thanh Sang Le
Amarnath Rambhatla
Rupin Shah
Ashok Agarwal
Medical treatment prior to micro-TESE
Asian Journal of Andrology
aromatase inhibitors
gonadotropins
male infertility
microsurgical testicular sperm extraction
nonobstructive azoospermia
selective estrogen receptor modulators
successful sperm retrieval
title Medical treatment prior to micro-TESE
title_full Medical treatment prior to micro-TESE
title_fullStr Medical treatment prior to micro-TESE
title_full_unstemmed Medical treatment prior to micro-TESE
title_short Medical treatment prior to micro-TESE
title_sort medical treatment prior to micro tese
topic aromatase inhibitors
gonadotropins
male infertility
microsurgical testicular sperm extraction
nonobstructive azoospermia
selective estrogen receptor modulators
successful sperm retrieval
url https://journals.lww.com/10.4103/aja202492
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