{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:49:28Z","timestamp":1781520568896,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2023,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Due to the heterogeneous distribution of seminiferous tubules (STs) in patients with nonobstructive azoospermia (NOA), retrieving enough good quality spermatozoa for ICSI may require a complete testicular dissection. According to the only available study in this field, spermatozoa may be found in the testis surface in 34.2% of patients, while a deeper testicular dissection is able to provide spermatozoa for ICSI in 28% of those without spermatozoa in the testis surface.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To determine the probability of finding enough spermatozoa for ICSI at the initial wide incision of the testis in a cohort of men with NOA undergoing microdissection testicular spermatozoa extraction (mTESE).<\/jats:p><\/jats:sec>Materials and methods<\/jats:title>We evaluated 276 patients, aged 37 (20\u201362) years, who underwent unilateral (86, 31.15%) or bilateral (190, 68.8%) mTESE from January 2018 through December 2021. During mTESE, the entire surface of the testicular parenchyma was explored first in search for dilated STs: if no\/ not enough spermatozoa were retrieved, the deeper portion of the parenchyma was explored.<\/jats:p><\/jats:sec>Results<\/jats:title>Spermatozoa were retrieved in 137 patients (49.6%). Histopathology demonstrated Sertoli\u2010cell only syndrome in 65.6% of operated testes, while maturation arrest was found in 19.5%, hypospermatogenesis (HS) in 12.7%, and hyalinosis in 2%. Spermatozoa were obtained from the testis surface in 46 of 276 patients (16.6%), and after a complete dissection in 91 subjects (32.9%). On multivariate logistic regression, only the histopathological subcategory HS was predictive of the chance of retrieving spermatozoa from the surface of the testis (OR 3.24, 95% CI 1.37\u20137.69, p<\/jats:italic>\u00a0=\u00a00.007).<\/jats:p><\/jats:sec>Discussion<\/jats:title>Most patients with NOA, particularly those with unfavorable histopathological patterns, require a complete dissection of the testicular parenchyma to obtain enough good quality for ICSI.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>By enabling the complete exploration of the testicular parenchyma, mTESE is to be preferred to cTESE to retrieve spermatozoa in patients with NOA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13344","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T10:08:49Z","timestamp":1669198129000},"page":"508-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A complete dissection of the whole testicular parenchyma is required in most patients with nonobstructive azoospermia to obtain enough good quality testicular spermatozoa for ICSI"],"prefix":"10.1111","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8411-2736","authenticated-orcid":false,"given":"Ettore","family":"Caroppo","sequence":"first","affiliation":[{"name":"Asl Bari, Reproductive Unit Andrology Outpatients Clinic PTA \u201cF Jaia,\u201d Conversano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Castiglioni","sequence":"additional","affiliation":[{"name":"Next Fertility Procrea Andrology Unit Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Nerva","sequence":"additional","affiliation":[{"name":"Next Fertility Milano Andrology Unit Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta Maria","family":"Colpi","sequence":"additional","affiliation":[{"name":"Next Fertility Procrea Andrology Unit Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Gazzano","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano IRCCS Pathology Unit Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1431-1777","authenticated-orcid":false,"given":"Giovanni Maria","family":"Colpi","sequence":"additional","affiliation":[{"name":"Next Fertility Procrea Andrology Unit Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2047-2927.2013.00148.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.07.1136"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmz028"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmaa006"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12548"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(00)00901-8"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.09.031"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10194296"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000001951"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/14647273.2018.1472396"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.09.024"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-4-1"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2015.01.029"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/and.12362"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-018-1304-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0113671"}],"container-title":["Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13344","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/andr.13344","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T22:18:43Z","timestamp":1692397123000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/andr.13344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,9]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/andr.13344"],"URL":"https:\/\/doi.org\/10.1111\/andr.13344","archive":["Portico"],"relation":{},"ISSN":["2047-2919","2047-2927"],"issn-type":[{"value":"2047-2919","type":"print"},{"value":"2047-2927","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,9]]},"assertion":[{"value":"2022-05-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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