Our Summary

Cryptorchidism, a condition where one or both of the testes fail to descend, is a common cause of male infertility. A common treatment is a surgical procedure called microdissection testicular sperm extraction (m-TESE), which retrieves sperm. However, there’s still a lot of uncertainty about how successful this procedure is and what factors could influence its success after cryptorchidism surgery.

This study looked at the results of m-TESE in 935 patients who had undergone cryptorchidism surgery. They found that, on average, 57% of the time the procedure successfully retrieved sperm.

They also found that the age a patient had the surgery to correct cryptorchidism (orchidopexy) and the age they had m-TESE mattered. Those who had orchidopexy at a younger age and m-TESE at an older age were more likely to have successful sperm retrieval. The location of the undescended testis also mattered, with those closer to the scrotum having a higher success rate.

Levels of certain hormones and the size of the testes didn’t seem to make a difference to the success rate. Surprisingly, patients who had their m-TESE procedure sooner after their orchidopexy tended to have less successful results.

In summary, to increase the chances of successful sperm retrieval, surgery to correct cryptorchidism should be done as early as possible, and m-TESE should be performed much later. The optimal time gap between these two procedures still needs further study.

FAQs

  1. What is cryptorchidism and how does it impact male fertility?
  2. What factors were found to influence the success of sperm retrieval after cryptorchidism surgery?
  3. What is the recommended timing for surgery to correct cryptorchidism and the m-TESE procedure to increase the chances of successful sperm retrieval?

Doctor’s Tip

It’s important to follow up with your doctor regularly after undergoing undescended testicle surgery to monitor your fertility and discuss any concerns. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can also help improve fertility outcomes. If you have any questions or concerns about your fertility after surgery, don’t hesitate to discuss them with your healthcare provider.

Suitable For

Overall, patients who are recommended undescended testicle surgery are those with cryptorchidism who are looking to improve their fertility potential. It is important for these patients to undergo surgery at a young age and to consider m-TESE as a potential option later on to retrieve sperm. Additionally, the location of the undescended testis may also play a role in the success of the procedure. Patients should discuss their options with their healthcare provider to determine the best course of action for their individual situation.

Timeline

Timeline:

Before undescended testicle surgery:

  • Patient is diagnosed with cryptorchidism, one or both testes fail to descend
  • Patient undergoes orchidopexy surgery to correct the undescended testicle
  • Patient may experience infertility due to the condition
  • Patient may consider m-TESE procedure to retrieve sperm

After undescended testicle surgery:

  • Patient undergoes m-TESE procedure to retrieve sperm
  • On average, 57% of the time the procedure successfully retrieves sperm
  • Factors such as age at orchidopexy and m-TESE, location of undescended testis, and timing of m-TESE after orchidopexy can influence success rate
  • Patients who had orchidopexy at a younger age and m-TESE at an older age were more likely to have successful sperm retrieval
  • Levels of hormones and testes size did not impact success rate
  • Patients who had m-TESE sooner after orchidopexy tended to have less successful results
  • Further study is needed to determine the optimal time gap between orchidopexy and m-TESE for successful sperm retrieval.

What to Ask Your Doctor

  1. What is the success rate of m-TESE in patients who have undergone cryptorchidism surgery?

  2. How does the age at which I had cryptorchidism surgery and the age at which I have m-TESE affect the success of sperm retrieval?

  3. Does the location of the undescended testis impact the success rate of m-TESE?

  4. Do levels of hormones or the size of the testes play a role in the success of m-TESE?

  5. Is there an optimal time gap between cryptorchidism surgery and m-TESE to increase the chances of successful sperm retrieval?

  6. What are the potential risks and complications associated with m-TESE?

  7. What is the recovery process like after m-TESE surgery?

  8. Are there any alternative treatments or procedures available for sperm retrieval in patients with cryptorchidism?

  9. How will the success of m-TESE impact my chances of fertility and future fertility treatments?

  10. Are there any lifestyle changes or precautions I should take before or after m-TESE surgery to optimize the chances of successful sperm retrieval?

Reference

Authors: He HN, Xiao H, Yao RJ, Liao SJ, Zheng JH, Zhou HL. Journal: PLoS One. 2024 Nov 15;19(11):e0313866. doi: 10.1371/journal.pone.0313866. eCollection 2024. PMID: 39546484