Redo testicular sperm aspiration (TESA) in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA)
Bibliographic record
Abstract
BACKGROUND: Testicular sperm aspiration (TESA) is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility. We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia (OAT) and obstructive azoospermia (OA). METHODS: This is a retrospective analysis of consecutive TESAs (primary and redo) for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center. We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit. RESULTS: 439 TESAs (366 primary and 73 redo) in men with severe OAT (n = 133) and OA (n = 306) were included. Men with OA had significantly higher sperm retrieval rate (SRR) and motile SRR compared to men with severe OAT (99% vs. 95% and 98% vs. 83%, respectively, p < 0.05). The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT (15% vs. 32% and 1.2 ± 0.5 vs. 1.4 ± 0.7, respectively, p < 0.05). In both groups, SRR, motile SRR, the requirement for multiple biopsies, and the total number of aspirates were not significantly different in primary compared to redo cases. CONCLUSION: Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT. The data also demonstrate that a redo TESA in these men is as effective as a primary TESA, suggesting that areas of active spermatogenesis are preserved 6 months after TESA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".