MESA, TESE, MicroTESE

MESA, TESE, MicroTESE

1. MESA, TESE, MicroTESE Sandro C. Esteves Diretor Médico e Científico , ANDROFERT Campinas, São Paulo XXXV Congresso Brasileiro de Urologia Rio de Janeiro, Novembro 2015 – C37

2. Técnicas de C aptação de Espermatozoides para Reprodução Assistida (ICSI) Esteves et al. Sperm Retrieval Techniques. Int Braz J Urol 2011; 37: 570-83 Acrônimo Técnica MESA M icrosurgical E pididymal S perm A spiration TESE Te sticular S perm E xtraction Micro-TESE Micro dissection Te sticular S perm E xtraction ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 2 2015 ANDROFERT

3. Azoospermia Obstrutiva Technique Acronym Percutaneous Epididymal Sperm Aspiration PESA Microsurgical Epididymal Sperm Aspiration MESA Testicular Sperm Aspiration TESA Esteves & Agarwal . Sperm Retrieval Techniques. Cambridge University Press , 2011 ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 3 2015 ANDROFERT

4. Microsurgical Epididymal Sperm Aspiration (MESA) ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 5 2015 ANDROFERT Cortesia Dr. Marcello Cocuzza

5. Esteves SC, Int Braz J Urol 2015; 41:817-8. Available at: www.brazjurol.com.br /videos/july_august_2015/Esteves_817_818video.htm

6. MESA vs PESA MESA PESA Efetividade ( Sptz +) ~100% ~100% Eficiência (No. Sptz ) +++ ++ Criopreservação ~100% casos 1/3 casos Custo-efetividade NA NA Complexidade +++ + Complicações ++ + (8/146=5.5%)* Repetição Sim Sim Efetividade ICSI ~40% NV/TE Miyaoka & Esteves. Clinics 2013; 68 Suppl 1 : 111 -9. *Esteves et al. J Urol. 2013; 189(1): 232-7

7. Esteves et al. J Urol. 2013; 189(1): 232-7 146 patients Sperm retrieval in CBAVD ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 8 2015 ANDROFERT 78.1% ~100%

8. Azoospermia Não-obstrutiva Técnica Acrônimo Tx sucesso Testicular Sperm Aspiration TESA 15-50% Testicular Sperm Extraction TESE 20-60% Microsurgical Testicular Sperm Extraction Micro-TESE 40-67% Esteves & Agarwal . Sperm Retrieval Techniques. Cambridge University Press , 2011 ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 10 2015 ANDROFERT

9. Micro-TESE vs TESE: Efetividade Controlled series (N=60) Histology categories p airwise comparisons: p<0.0001 Method P=0.0005 Verza Jr & Esteves. Fertil Steril 2011; 96 (Suppl.): S53 ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 13 2015 ANDROFERT

10. Tissue removed (mg) Conventional TESE Micro-TESE P-value 65 ± 25 8.9 ± 2.5 <0.01 Conventional TESE Micro-TESE Esteves & Varghese J Reprod S ci 2012; 5: 233-43. ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 14 2015 ANDROFERT Micro-TESE vs TESE: Eficiência

11. P<0.01 ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 15 2015 ANDROFERT

12. Obrigado Acesse http:// www.slideshare.net / sandroesteves

13. http://androfert.com.br/videos Esteves SC, Int Braz J Urol 2013 ANDROLOGY AND HUMAN REPRODUCTION CLINIC - REFERRAL CENTER FOR MALE REPRODUCTION S ESTEVES, 17 2015 ANDROFERT