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Review
. 2020 Mar;9(Suppl 2):S206-S214.
doi: 10.21037/tau.2019.08.36.

Towards a better testicular sperm extraction: novel sperm sorting technologies for non-motile sperm extracted by microdissection TESE

Cathy L Mangum  1 , Darshan P Patel  1 , Alexander R Jafek  2 , Raheel Samuel  2 , Tim G Jenkins  1   3 , Kenneth I Aston  1   3 , Bruce K Gale  2 , James M Hotaling  1   3
Affiliations
Review

Towards a better testicular sperm extraction: novel sperm sorting technologies for non-motile sperm extracted by microdissection TESE

Cathy L Mangum et al. Transl Androl Urol. 2020 Mar.

Abstract

Non-obstructive azoospermia (NOA) is the most severe form of male factor infertility. It is characterized by a lack of spermatogenesis in the seminiferous tubules. Microdissection testicular sperm extraction (microTESE) has significantly improved testicular sperm retrieval rates compared to conventional techniques for NOA. Following testicular biopsy, the sperm is usually non-motile and contained within seminiferous tubules requiring extensive laboratory processing to find individual sperm sufficient for artificial reproductive technologies (ART). Current techniques include mechanical and enzymatic processing which is time-consuming and often damaging to sperm. We review novel techniques that may help improve sperm retrieval rates after microTESE including microfluidics (dielectrophoretic cell sorting, spiral channel sorting, and pinched flow fractionation), fluorescence-activated cell sorting (FACS), and magnetic-activated cell sorting (MACS).

Keywords: Microfluidics; azoospermia/therapy; intracytoplasmic/methods; male; microdissection/methods; sperm injections; sperm retrieval; sperm separation.

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Conflict of interest statement

Conflicts of Interest: The focused issue “Contemporary Issues and Controversies in Men’s Health” was commissioned by the editorial office without any funding or sponsorship. JMH serves as an unpaid editorial board member of Translational Andrology and Urology from Aug 2019 to Jul 2021. R Samuel: Nanonc—equity stake; wFluidX Inc.—equity stake. TG Jenkins: Nanonc (microfluidic sperm sorting company, inherent biosciences—leadership position/founder. KI Aston: Nanonc—equity stake. BK Gale: Nanonc—equity stake. JM Hotaling: Boston Scientific, Endo Pharmaceuticals—research and fellowship grant; Nanonc, StreamDx, Andro360, inherent biosciences—leadership position/founder. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Illustrations of microfluidics devices for non-motile cell sorting.
See this image and copyright information in PMC

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