Factores predictivos de recuperación espermática en las azoospermias

Bonarriba, Carlo R.; Burgués, J.P.; Vidaña, V. Tubau; Ruíz, Xavier; Piza, Pedro de Toledo

doi:10.1016/j.acuro.2012.06.002

Cited by 13 publications

(9 citation statements)

References 29 publications

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“…Men with NOA usually have smaller testicles than men with obstructive azoospermia 5 , except those with early or late maturation arrest histology 6 . Studies to date, however, have only shown poor correlations between testicular size and sperm retrieval rates, 7,8 though no study has specifically evaluated the effectiveness of micro-TESE in men with severe testicular atrophy.…”

Section: Introductionmentioning

confidence: 99%

Severe Testicular Atrophy does not Affect the Success of Microdissection Testicular Sperm Extraction

et al. 2014

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Introduction and Objectives Men with azoospermia and severe testicular atrophy may be counseled to avoid sperm retrieval due to perceived limited success. We evaluated the outcomes of microdissection testicular sperm extraction (micro-TESE) in men with severe testicular atrophy (volume ≤ 2 mL). Methods We reviewed the records of 1127 men with nonobstructive azoospermia who underwent micro-TESE followed by intracytoplasmic sperm injection. The men were classified into three groups based on average testicular volume (mL), ≤2, >2–10, >10. Sperm retrieval, clinical pregnancy, and live birth rates were calculated. The clinical features evaluated included age, FSH level, history of cryptorchidism, Klinefelter syndrome, varicocele, and testicular histology from diagnostic biopsy. Result(s) Testicular sperm were successfully retrieved in 56% of the men. Sperm retrieval rates (SRR) in men with testicular volumes of ≤ 2, >2–10, and >10 mL was 55%, 56% and 55% respectively. Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the three groups (55.2%, 50.0%, and 47.0%; and 47.2%, 43.0% and 42.2% respectively). Of the 106 men with average testis volume ≤ 2 mL bilaterally, men who had sperm retrieved were younger (31.1 vs. 35.2 years), and were more likely to have a history of Klinefelter syndrome (82.2% vs 55.6%) compared to those in whom sperm was not found (p < 0.05). Men in this group had a higher prevalence of Klinefelter syndrome than men with testis >2 mL (72.6% vs 5.3%, p<0.0001). Men younger than 30 years with Klinefelter syndrome had a higher SRR (81.8%) compared to men older than 30 without Klinefelter syndrome (33%, p<0.01). There was no cut-point for age beyond which sperm could not be retrieved in men with small testes. On multivariable analysis, younger age was the only preoperative factor associated with successful sperm retrieval in men with small testes (<2mL). Conclusion(s) Testicular volume does not affect sperm retrieval rates at our center with micro-TESE. For men with the smallest volume testes, those younger men with Klinefelter syndrome had the highest sperm retrieval rates. Severe testicular atrophy should not be a contraindication for micro-TESE.

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Section: Introductionmentioning

confidence: 99%

Severe Testicular Atrophy does not Affect the Success of Microdissection Testicular Sperm Extraction

et al. 2014

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“…These data are similar to those reported in the existing literature (45%–63%; 2–5, 11–13). In general, when cTESE is used, the success rates of sperm retrieval in NOA patients are reported to be33.7%–50.9% [ 11 , 12 , 13 , 14 , 15 , 16 ], however, lower rates are reported to be 16%–33% [ 17 ]. SRR from cTESE is lower than that for micro-TESE, which commonly shows rates of50.8%–56.0% [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Optimized cut-off value for bilateral testicular volume was 11mL, and optimized cut-off values for serum E 2 levels in the left and right testes were 144.5 pmol/L and 133.5 pmol/L, respectively. Bonarriba et al also reported cut-off points determined using ROC curves were 67 pg/mL for inhibin B (INH-B) and 12.2 mUI/mL for FSH [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…We found that parameters to forecast testicular SRR have become the particular focus of research over recent years. Researchers have considered several parameters which could act as predictors, including age, testicular volume, histopathology (hypospermatogenesis and Johnsen score), serum FSH, INH-B, TT levels, Y chromosomal microdeletions and family history [ 8 , 14 , 24 , 25 ]. However, other researchers have some that parameters could not be treated as predicators, including age, testicular volume, histopathology (hypospermatogenesis), previous negative TESE, serum FSH, LH, INH-B levels, seminal plasma INH-B, and anti-Müllerian hormone [ 7 , 16 , 21 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some previous literature has supported that there was a good correlation between the histology found upon diagnostic biopsy, testicular volume and the likelihood of finding mature sperm cells during testicular sperm retrieval or ICSI [ 12 , 24 ]. However, other papers disagreed with this viewpoint [ 14 , 24 ], and reported that there was no relationship between SRR and FSH levels [ 7 , 12 ]. Researchers found that low INH-B and high FSH levels were correlated to sperm retrieval failure and that lower INH-B was more related to sperm retrieval failure than higher FSH.…”

Section: Discussionmentioning

confidence: 99%

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A clinical trial on the consistency of bilateral testicular tissue histopathology and Johnsen score: single side or bilateral side biopsy?

et al. 2018

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To evaluate and compare left and right testicular tissue histopathology and Johnsen score, and to investigate the necessity for bilateral testicular biopsy. We recruited180 patients with non-obstructiveazoospermia (NOA) on testicular biopsy who had undergonetesticular sperm aspiration (TESA). Pathological sections of testicular tissue were diagnosed by specially-assigned doctors, who evaluated pathological findings, determined the Johnsen score and confirmed for the presence or absence of sperm. Sperm positive rates for left and right testicular histopathology were 55.0% and 51.7% respectively, and the proportion of Johnsen scores≥8 for left and right testes were 53.3% and 50.0%, respectively. Cohen kappa values revealed that the identification of sperm in bilateral testicular samples was not consistent and was related to random effects; Optimized cut-off value for bilateral testicular volume was 11ml (Johnsen score ≥8), and optimized cut-off values of E2 on left and right testes were 144.5pmol/L and 133.5 pmol/L (Johnsen score≤7). However, age, serum prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH) and total testosterone (TT) levels were not accurate predictors for the existence of testicular sperm. There was nostatistical significance between left and right testicular histopathology in terms of sperm positive rates or Johnsen score; the Johnsen score were caused entirely by random effects and a score from one side could not represent the other side. Therefore, we recommend that both testes need to undergo surgery when NOA patients undergo testicular biopsy or sperm retrieval.

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Hormonal markers as noninvasive predictors of sperm retrieval in non-obstructive azoospermia

Zarezadeh

Fattahi

Nikanfar

et al. 2021

J Assist Reprod Genet

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Non-obstructive azoospermia (NOA) is one of the leading causes of male factor infertility, which results from impaired spermatogenesis. Currently, the sole feasible therapeutic option for men with NOA to father their biologic children is sperm retrieval by testicular sperm extraction (TESE) approaches followed by an intracytoplasmic sperm injection program. Nevertheless, the rate of sperm retrieval from NOA men following TESE has remained as low as 50%, leading to a significant number of unsuccessful TESE operations. Given that TESE is associated with multiple side effects, the prediction of TESE outcome preoperatively can abolish unnecessary operations and thereby prevent NOA patients from sustaining adverse side effects. As the process of spermatogenesis is under the regulation of hormones, the hormonal profile of serum and/or seminal plasma may contain useful information about spermatogenesis status and can potentially predict the chance of sperm retrieval from NOA patients. A large body of literature is available on the predictive capability of different serum and seminal plasma hormones such as FSH, LH, testosterone, inhibin B, AMH, estradiol, prolactin, and leptin in a stand-alone basis or combinational fashion with respect to the TESE outcome. The present review aimed to evaluate the potential of these hormonal markers as noninvasive predictors of sperm retrieval in men with NOA.

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Factores predictivos de recuperación espermática en las azoospermias

Cited by 13 publications

References 29 publications

Severe Testicular Atrophy does not Affect the Success of Microdissection Testicular Sperm Extraction

Severe Testicular Atrophy does not Affect the Success of Microdissection Testicular Sperm Extraction

A clinical trial on the consistency of bilateral testicular tissue histopathology and Johnsen score: single side or bilateral side biopsy?

Hormonal markers as noninvasive predictors of sperm retrieval in non-obstructive azoospermia

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