Standard IV Cannula Aspiration (SIVCA): A Novel, Efficient and Minimally Invasive Testicular Sperm Aspiration Technique
Condition: Non Obstructive Azoospermia
MeSH terms: Azoospermia
Study type: Interventional

Summary: 
      Study question:

      Can enough testicular tissue be aspirated for sperm retrieval in non-obstructive azoospermia
      (NOA), using a wide bore 14-G Standard IV cannula in comparison to micro-TESE?

      Summary answer:

      Standard IV cannula Aspiration (SIVCA) can yield an ample amount of testicular tissue
      sufficient for sperm retrieval through a single puncture site on the scrotum.
    

Detailed description: 
      What is known already:

      The current conventional method of testicular sperm aspiration is fine needle aspiration
      (FNA). FNA has the advantage of being a cost-effective and minimally invasive procedure
      compared to open testicular sperm extraction (TESE). But FNA with its conventional 23-G
      needle may not always yield enough testicular tissue for sperm retrieval. Furthermore, FNA
      may require multiple punctures on the scrotum to retrieve enough tissues from different areas
      of the testis.

      Study design, size, duration:

      A 24 months prospective cohort study conducted at a specialized IVF center. A total of 130
      men aged from 22 to 53 years old (35.03 +/- 9.04) with NOA and normal testicular volume (≥
      12ml) were enrolled in the study. The men had testicular biopsies taken at the day of their
      partners' ovum pick-up. On each patient, the testes were randomized to undergo SIVCA on one
      testis followed by micro-TESE on the contralateral testis.

      Participants/materials, setting, methods:

      After local anesthesia, a wide bore 14-G standard IV cannula was introduced near the lower
      pole of the testis. The needle was withdrawn and the catheter introduced into the testicular
      tissue. A 20-ml syringe was secured to the catheter and constant negative pressure applied
      and secured with a clamp. Back and forth motions were performed covering as many areas of the
      testis as possible. Micro-TESE was then performed on the contralateral testis.Sperm retrieval
      rates (SRR) will be compared between the two techniques using McNemar χ2 test. A P-value of
      less than 0.05 was considered to be statistically significant.
    

Intervention name(s): Standard IV Cannula for aspiration of testicular sperm; Micro-TESE
Intervention type(s): Device; Procedure
Intervention description(s): After local anesthesia, a wide bore 14-G standard IV cannula was introduced near the lower pole of the testis. The needle was withdrawn and the catheter introduced into the testicular tissue. A 20-ml syringe was secured to the catheter and constant negative pressure applied and secured with a clamp. Back and forth motions were performed covering as many areas of the testis as possible.; Conventional Microscopic Testicular Sperm Extraction (Micro-TESE), Open Testicular Biopsy using surgical Microscope
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: On each patient, the testes were randomized to undergo testicular sperm aspiration using a standard IV cannula on one side, followed by surgical microscopic testicular sperm extraction on the contralateral testis.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Non Obstructive Azoospermia; Fine Needle Aspiration; Micro-TESE