Onco-Testicular Sperm Extraction (oncoTESE): A Contemporary Concept Review and Report of Australian Sperm Retrieval Rates and Fertility Outcomes - Beyond the Abstract

The recent article by Blecher et al highlights the possibility and indeed clinical relevance of oncoTESE. OncoTESE involves harvesting sperm from a radical orchidectomy specimen, for men with severely low or absent sperm production. This procedure is not novel, nor complicated. However, it requires some training and experience. But more importantly, it necessitates an intention to bring what many may consider a basic fertility right, to our patients.

OncoTESE often involves both urologist and a fertility preservation scientist/embryologist and a facility capable of cryopreservation. In Australia, this is not offered at most public hospitals. As such, a particular effort to coordinate the procedure is needed. This is but one barrier - there are others. It is of interest to note the overall numbers of patients, aside from the primary outcome measures of the study.

Only four surgeons across Australia had any cases to contribute to this study, highlighting the lack of expertise in oncoTESE, which urologists are simply, well placed to deliver. Whilst we look forward to furthering studies demonstrating clinical utility and effectiveness, we anticipate a wider uptake of this simple surgery.

Written by: Dr. Gideon Blecher, Urological Surgeon, Monash University. Melbourne, Australia

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