Popular Male Infertility Procedure Carries Risk of Testosterone Impairment

Study at renowned Turek Clinic highlights need for precision diagnostics to make microTESE surgeries safer long-term

LOS ANGELES, May 5, 2022 /PRNewswire/ -- New research reveals the risk of long-term testosterone impairment for men undergoing microTESE, a popular surgery that enables men with nonobstructive azoospermia to become fathers. Led by Dr. Paul Turek, the study points to the need for precision diagnostics prior to invasive sperm retrieval surgeries.

"The surgical complication that worries me most is lowering men's testosterone levels for life," says Dr. Paul Turek, Director and Founder of The Turek Clinic, a men's health medical practice and senior author of newly published research in the Journal of Reproduction and Genetics that addresses the subject. He added, "It's the other job of the testicle to make testosterone, and this process is at risk when sperm retrieval surgeries are undertaken 'blindly,' that is without diagnostic guidance."

The study compared testosterone levels in men before and after blind microTESE (microdissection testicular sperm extraction) surgical procedures. The goal was to define what proportion of men did not recover testosterone levels after having surgery and how many might require lifelong testosterone replacement. 

More than 700 patients from around the world who had had microTESE procedures and were then seen at The Turek Clinic were recruited over a 9-year period. Conditions that lower testosterone levels such as age and obesity were taken into consideration. Testosterone and other reproductive hormones were compared before microTESE procedures and an average of 26 months afterward.

The study found no significant differences in baseline testosterone levels between microdissection patients (n=26) and sterile controls (n=52). However, men who had microTESE procedures showed a significant decrease in mean testosterone levels after surgery. In addition, among men with normal testosterone balance (>300ng/dL) before microTESE procedures, more than one third (36%) had clinically low testosterone levels (<300ng/dL) at an average of 2 years after the procedure.

"Our findings show that microTESE procedures, when done blind, can cause serious and potentially permanent impairments to testosterone production by the testicle," noted Dr. Turek. "A diagnostic technology such as Sperm Mapping when performed before surgical sperm retrieval 'unblinds' the process by informing it about sperm presence and location, minimizing the need for and extent of microTESE procedures and thereby reducing the risk to testosterone levels."

Sperm Mapping, also known as "FNA Mapping" or "Testicular Mapping" is a minimally invasive technique that locates sperm in "hidden" areas of the testes that may go undetected in conventional sperm extraction procedures.

About Paul Turek, MD
Dr. Paul Turek is founder of The Turek Clinic, leading male fertility and sexual health clinics for men worldwide. He is former Endowed Chair Professor at the University of California San Francisco and inventor of sperm mapping for the treatment of severe male infertility. As a master microsurgeon, he popularized the No-Scalpel Vasectomy and has among the highest published vasectomy reversal success rates. He received a prestigious National Institutes of Health (NIH) grant and is an advisor to the NIH and Centers for Disease Control and Prevention. For more information, visit TheTurekClinic.com. 

SOURCE The Turek Clinic