Factors predicting successful sperm retrieval in men with nonobstructive Azoospermia: A single center perspective

Abstract

Predicting successful sperm retrieval is essential in counseling infertile men with Azoospermia.Objectives: To assess the predictors of successful sperm extraction in men with nonobstructive Azoospermia.Patients and Methods: A retrospective study included all patients with nonobstructive Azoospermia from January 2018 to May 2019. Subdivided into two groups, group I (negative sperm retrieval) and group II (positive sperm retrieval).Results: A total of 108 patients with a mean age of 36.8 ± 10 years were included.The rate of successful sperm retrieval was 47.2%. Group I included 57 patients (52.8%) with a mean age of 33.98 ± 6.18, and group II included 51 patients (47.2%) with a mean age of 40.04 ± 12.22 (p = 0.008). Follicular stimulating hormone (FSH) levels were significantly higher in group I (18.55 ± 13 vs. 7.97 ± 7.11; p < 0.004).Similarly, in group I, luteinizing hormone was significantly higher (11.4 ± 7.45 vs. 5.9 ± 4.4; p < 0.001). Age and FSH were the independent predictors of successful micro-TESE. Additionally, successful pregnancies were 13.7% of patients, 28.6% of which gave rise to living birth. Conclusion:Patients' age and serum FSH are independent predictors of successful sperm retrieval for infertile men with nonobstructive Azoospermia; young patients with high FSH levels could have little chance of sperm retrieval.

Role of Follicle-stimulating Hormone, Inhibin B, and Anti-Müllerian Hormone in Predicting Sperm Retrieval from Men with Nonobstructive Azoospermia Undergoing Microdissection Testicular Sperm Extraction: A Systematic Review and Meta-analysis

“…Numerous studies have investigated the predictive potential of FSH [8] , [11] , [12] , [13] , [14] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] . Given that FSH directly stimulates Sertoli cells within the testes to initiate spermatogenesis, the hypothesis emerged that FSH levels might serve as an indicator of testicular function and thus of the success of SR at mTESE [10] , [21] .…”

“…Conflicting results have emerged over time. For instance, Tsujimura et al [11] , [22] found that FSH was the most influential preoperative factor, together with InhB and total testosterone, in predicting SR. Aljubran et al [26] found that patient age and baseline serum FSH were independently associated with +SR among men with NOA undergoing mTESE. Conversely, more recent studies have found the opposite.…”

Effectiveness of, and Satisfaction with, a Microsurgical Testicular Sperm Extraction Knowledge and Skills Masterclass for a World-Wide Audience

“…Yet, in andrology, when the current and ‘recently published’ mTESE literature is examined e.g. , when mTESE in NOA men is summarized [ 34 ]; or when factors predicting successful sperm retrieval among NOA men are assessed [ 13 ]; or when mTESE sperm extraction results of the first 100 patients are appraised [ 31 ]; or when the clinical experience of mTESE is evaluated [ 35 ], there is lack of acknowledgement of the need for skill building courses, such as the one described and evaluated here, to improve andrologists’ ability to perform mTESE optimally.…”

“…Further specialized knowledge is also required for patient-related and intra-operative predictors of mTESE success. A recent systematic review and meta-analysis as well as a range of studies found that age, testicular volume, follicle-stimulating hormone, luteinizing hormone, and testicular histopathology were valuable predictors of salvage mTESE extraction in NOA [ 12 13 ]. Furthermore, others proposed molecular biomarkers and noncoding RNAs in seminal plasma as predictors of sperm recovery [ 1 14 ].…”