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Azoospermia, NonobstructiveNCT06702397

TeSE (Testicular Sperm Extraction) in Azoospermic Patients: m-TeSE vs. l-TeSE

A study testing Microscope and Surgical loupes in people with Azoospermia, Nonobstructive, run by A.O.U. Città della Salute e della Scienza at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of the study is to compare surgical outcomes (intra and post-operative complications) and sperm retrieval rates between conventional microsurgical-assisted testicular sperm extraction (m-TeSE - Group A) and testicular sperm extraction performed with surgical loupes (l-TeSE - Group B) in adult males with… Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Azoospermia, Nonobstructive
What is being tested?
Microscope and Surgical loupes
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
1 siteItaly
Study dates
1 Mar 2022to 30 Apr 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult males
  • Diagnosis of non obstructive azoospermia who required m-TeSE.

Who cannot join

  • Absence of signed written informed consent
  • Age < 18 years
  • Obstructive azoospermia
  • Genetic anomalies (e.g., Klinefelter syndrome, Kallmann syndrome, Y chromosome microdeletions, CFTR mutations)
  • Previous testicular biopsies/surgical sperm retrieval
  • Personal history of malignant testicular tumor
Show all 10Show fewer
  • Unilateral cryptorchidism
  • Varicocele
  • Previous chemotherapy/radiotherapy treatments
  • Monorchidism

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Molinette - AOU Città della Salute e della Scienza di Torino

    Turin, 10126

Other trials in Italy

About this study

Official title: Preliminary Results of Microsurgical Testicular Exploration for Sperm Retrieval in Azoospermic Patients: A Randomized Controlled Trial Comparing Operating Microscope vs. Surgical Loupes

The aim of the study is to compare surgical outcomes (intra and post-operative complications) and sperm retrieval rates between conventional microsurgical-assisted testicular sperm extraction (m-TeSE - Group A) and testicular sperm extraction performed with surgical loupes (l-TeSE - Group B) in adult males with non-obstructive azoospermia.

Read the detailed description

Objective: To compare surgical outcomes and sperm retrieval rates (SRR) between conventional microsurgical-assisted testicular sperm extraction (m-TeSE - Group A) and testicular sperm extraction performed with surgical loupes (l-TeSE - Group B) in adult males with non-obstructive azoospermia (NOA). A multicentric prospective randomized trial was conducted from March 2022. Adult males with NOA without genetic alterations who agreed to participate in the study and signed the required informed consent were enrolled. SRR, intra and post-operative complications (according to Clavien-Dindo classification), hormonal profile tchanges were considered as outcomes during the follow up period.

Being tested
Microscope, Surgical loupes
Medical subject headings
Azoospermia, Nonobstructive

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MicroscopeDevice

    The microscope provides a direct examination of the testicular parenchyma at 20-25x magnification.

  • Surgical loupesDevice

    Surgical loupes offer magnification of 3.5-5x.

Study groups in NCT06702397
Study groupRoleWhat they receive
Microsurgical-assisted testicular sperm extraction (m-TeSE) - Group AActive comparatorA longitudinal incision of 3cm was made along the scrotal raphe using a scalpel. Surgical dissection proceeded layer by layer. The testis was separated from the surrounding dartos and luxated outside the scrotal sac. A longitudinal incision was made in the tunica vaginalis to allow complete exposure of the tunica albuginea. Two Vicryl 2-0 traction sutures were placed 0.5 cm cranially and caudally to the testicular equatorial line, which was subsequently incised with a scalpel for 3/4 of the testicular circumference. In M-TESE, through the operating microscope, a direct examination of the testicular parenchyma was performed under magnification (20-25x). Multiple testicular specimens were excised. The same procedure is performed on the contralateral side, where instead of the operating microscope, the surgeon uses surgical loupes for magnification (3.5 - 5x).
Receives: Device: Microscope
Testicular sperm extraction performed with surgical loupes (l-TeSE) - Group BActive comparatorA longitudinal incision of 3cm was made along the scrotal raphe using a scalpel. Surgical dissection proceeded layer by layer. The testis was separated from the surrounding dartos and luxated outside the scrotal sac. A longitudinal incision was made in the tunica vaginalis to allow complete exposure of the tunica albuginea. Two Vicryl 2-0 traction sutures were placed 0.5 cm cranially and caudally to the testicular equatorial line, which was subsequently incised with a scalpel for 3/4 of the testicular circumference. In M-TESE, through the operating microscope, a direct examination of the testicular parenchyma was performed under magnification (20-25x). Multiple testicular specimens were excised. The same procedure is performed on the contralateral side, where instead of the operating microscope, the surgeon uses surgical loupes for magnification (3.5 - 5x).
Receives: Device: Surgical loupes

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Positive sperm retrieval

    Number of sperm retrieval

    Measured: immediately after the surgery

  2. Histology

    Normal testicular biopsy or Hypospermatogenesis or Germ cell arrest or Sertoli cell-only syndrome or Seminiferous tubule hyalinization or CIS or Immature testis

    Measured: immediately after the surgery

  3. Johnsen score

    Number according to Johnsen score

    Measured: immediately after the surgery

  4. Sperm vials stored

    Number

    Measured: immediately after the surgery

Secondary outcomes (2)
  1. Operative time

    Minutes

    Measured: immediately after the surgery

  2. Complications

    Clavien dindo classification

    Measured: through study completion, an average of 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Nov 2024
  2. Study start1 Mar 2022
  3. Primary completion30 Apr 2024
  4. Study completion30 Apr 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized multi-center controlled trial comparing microsurgical-assisted testicular sperm extraction (m-TeSE - Group A) and testicular sperm extraction performed with surgical loupes (l-TeSE - Group B) in adult males with non-obstructive azoospermia (NOA) in terms of surgical outcomes and sperm retrieval rates
Masking
None (open label)
Enrolment
42 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06702397
Sponsor's protocol ID
202/2022
Status last verified
Nov 2024
First submitted
3 Nov 2024
Last updated
25 Nov 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Chen ML, Buncke GM, Turek PJ. Narrative review of the history of microsurgery in urological practice. Transl Androl Urol. 2021 Apr;10(4):1780-1791. doi: 10.21037/tau-20-1441.

    PubMed 33968665
  • Bernie AM, Mata DA, Ramasamy R, Schlegel PN. Comparison of microdissection testicular sperm extraction, conventional testicular sperm extraction, and testicular sperm aspiration for nonobstructive azoospermia: a systematic review and meta-analysis. Fertil Steril. 2015 Nov;104(5):1099-103.e1-3. doi: 10.1016/j.fertnstert.2015.07.1136. Epub 2015 Aug 8.

    PubMed 26263080
  • Flannigan R, Bach PV, Schlegel PN. Microdissection testicular sperm extraction. Transl Androl Urol. 2017 Aug;6(4):745-752. doi: 10.21037/tau.2017.07.07.

    PubMed 28904907
  • Li H, Chen LP, Yang J, Li MC, Chen RB, Lan RZ, Wang SG, Liu JH, Wang T. Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis. Asian J Androl. 2018 Jan-Feb;20(1):30-36. doi: 10.4103/aja.aja_5_17.

    PubMed 28361811
  • Pozzi E, Raffo M, Negri F, Boeri L, Sacca A, Belladelli F, Cilio S, Ventimiglia E, d'Arma A, Pagliardini L, Vigano P, Pontillo M, Luciano R, Colecchia M, Montorsi F, Alfano M, Salonia A. Anti-Mullerian hormone predicts positive sperm retrieval in men with idiopathic non-obstructive azoospermia-findings from a multi-centric cross-sectional study. Hum Reprod. 2023 Aug 1;38(8):1464-1472. doi: 10.1093/humrep/dead125.

    PubMed 37322566
  • Tournaye H, Liu J, Nagy PZ, Camus M, Goossens A, Silber S, Van Steirteghem AC, Devroey P. Correlation between testicular histology and outcome after intracytoplasmic sperm injection using testicular spermatozoa. Hum Reprod. 1996 Jan;11(1):127-32. doi: 10.1093/oxfordjournals.humrep.a019004.

    PubMed 8671174
  • Boeri L, Palmisano F, Preto M, Sibona M, Capogrosso P, Franceschelli A, Ruiz-Castane E, Sarquella-Geli J, Bassas-Arnau L, Scroppo FI, Sacca A, Gentile G, Falcone M, Timpano M, Ceruti C, Gadda F, Trost L, Colombo F, Rolle L, Gontero P, Montorsi F, Sanchez-Curbelo J, Salonia A, Montanari E. Sperm retrieval rates in non-mosaic Klinefelter patients undergoing testicular sperm extraction: What expectations do we have in the real-life setting? Andrology. 2020 May;8(3):680-687. doi: 10.1111/andr.12767. Epub 2020 Feb 16.

    PubMed 31999885
  • Ostad M, Liotta D, Ye Z, Schlegel PN. Testicular sperm extraction for nonobstructive azoospermia: results of a multibiopsy approach with optimized tissue dispersion. Urology. 1998 Oct;52(4):692-6. doi: 10.1016/s0090-4295(98)00322-7.

    PubMed 9763095
  • Pozzi E, Boeri L, Capogrosso P, Palmisano F, Preto M, Sibona M, Franceschelli A, Ruiz-Castane E, Sarquella-Geli J, Bassas-Arnau L, Scroppo FI, Gentile G, Falcone M, Timpano M, Ceruti C, Gadda F, Colombo F, Rolle L, Gontero P, Montorsi F, Sanchez-Curbelo J, Montanari E, Salonia A. Rates of hypogonadism forms in Klinefelter patients undergoing testicular sperm extraction: A multicenter cross-sectional study. Andrology. 2020 Nov;8(6):1705-1711. doi: 10.1111/andr.12843. Epub 2020 Jul 3.

    PubMed 32558292
  • Vieira M, Bispo de Andrade MA, Santana-Santos E. Is testicular microdissection the only way to retrieve sperm for non-obstructive azoospermic men? Front Reprod Health. 2022 Aug 23;4:980824. doi: 10.3389/frph.2022.980824. eCollection 2022.

    PubMed 36303631
  • Serletti JM, Deuber MA, Guidera PM, Reading G, Herrera HR, Reale VF, Wray RC Jr, Bakamjian VY. Comparison of the operating microscope and loupes for free microvascular tissue transfer. Plast Reconstr Surg. 1995 Feb;95(2):270-6. doi: 10.1097/00006534-199502000-00006.

    PubMed 7824606
  • Boeri L, Bebi C, Dente D, Greco E, Turetti M, Capece M, Cocci A, Cito G, Preto M, Pescatori E, Ciampaglia W, Scroppo FI, Falcone M, Ceruti C, Gadda F, Franco G, Deho F, Palmieri A, Rolle L, Gontero P, Montorsi F, Montanari E, Salonia A. Outcomes and predictive factors of successful salvage microdissection testicular sperm extraction (mTESE) after failed classic TESE: results from a multicenter cross-sectional study. Int J Impot Res. 2022 Dec;34(8):795-799. doi: 10.1038/s41443-021-00487-8. Epub 2021 Nov 6.

    PubMed 34743195
  • Falcone M, Boeri L, Timpano M, Cirigliano L, Preto M, Russo GI, Peretti F, Ferro I, Plamadeala N, Gontero P. Combined Trifocal and Microsurgical Testicular Sperm Extraction Enhances Sperm Retrieval Rate in Low-Chance Retrieval Non-Obstructive Azoospermia. J Clin Med. 2022 Jul 13;11(14):4058. doi: 10.3390/jcm11144058.

    PubMed 35887821
  • Schlegel PN, Su LM. Physiological consequences of testicular sperm extraction. Hum Reprod. 1997 Aug;12(8):1688-92. doi: 10.1093/humrep/12.8.1688.

    PubMed 9308794
  • Schoysman R, Vanderzwalmen P, Nijs M, Segal L, Segal-Bertin G, Geerts L, van Roosendaal E, Schoysman D. Pregnancy after fertilisation with human testicular spermatozoa. Lancet. 1993 Nov 13;342(8881):1237. doi: 10.1016/0140-6736(93)92217-h. No abstract available.

    PubMed 7901551

Questions about this trial

What is this clinical trial studying?

A study testing Microscope and Surgical loupes in people with Azoospermia, Nonobstructive, run by A.O.U. Città della Salute e della Scienza at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Positive sperm retrieval (time frame: immediately after the surgery). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06702397, which also lists 18 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Nov 2024.

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