Impact of testicular histopathology as a predictor of sperm retrieval and pregnancy outcome in patients with nonobstructive azoospermia: correlation with clinical and hormonal factors

Güler, İsmail; Erdem, Mehmet; Erdem, Ahmet; Demirdağ, Erhan; Tunç, Lütfi; Bozkurt, Nuray; Mutlu, Mehmet Fırat; Öktem, M.

doi:10.1111/and.12510

Cited by 31 publications

(36 citation statements)

References 35 publications

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“…Overall, the rate of successful sperm retrieval in NOA patients was previously estimated as 53% [28]. Rates varied for different histological subtypes of NOA: 81% for HS, 21% for MA, and 31% for SCO subtypes [28].…”

Section: Resultsmentioning

confidence: 99%

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Preclinical evaluation of a TEX101 protein ELISA test for the differential diagnosis of male infertility

Korbakis

Schiza

Brinc

et al. 2017

BMC Med

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BackgroundTEX101 is a cell membrane protein exclusively expressed by testicular germ cells and shed into seminal plasma. We previously verified human TEX101 as a biomarker for the differential diagnosis of azoospermia, and developed a first-of-its-kind TEX101 ELISA. To demonstrate the clinical utility of TEX101, in this work we aimed at evaluating ELISA performance in a large population of fertile, subfertile, and infertile men.MethodsMass spectrometry, size-exclusion chromatography, ultracentrifugation, and immunohistochemistry were used to characterize TEX101 protein as an analyte in seminal plasma. Using the optimized protocol for seminal plasma pretreatment, TEX101 was measured by ELISA in 805 seminal plasma samples.ResultsWe demonstrated that TEX101 was present in seminal plasma mostly in a free soluble form and that its small fraction was associated with seminal microvesicles. TEX101 median values were estimated in healthy, fertile pre-vasectomy men (5436 ng/mL, N = 64) and in patients with unexplained infertility (4967 ng/mL, N = 277), oligospermia (450 ng/mL, N = 270), and azoospermia (0.5 ng/mL, N = 137). Fertile post-vasectomy men (N = 57) and patients with Sertoli cell-only syndrome (N = 13) and obstructive azoospermia (N = 36) had undetectable levels of TEX101 (≤0.5 ng/mL). A cut-off value of 0.9 ng/mL provided 100% sensitivity at 100% specificity for distinguishing pre- and post-vasectomy men. The combination of a concentration of TEX101 > 0.9 ng/mL and epididymis-specific protein ECM1 > 2.3 μg/mL provided 81% sensitivity at 100% specificity for differentiating between non-obstructive and obstructive azoospermia, thus eliminating the majority of diagnostic testicular biopsies. In addition, a cut-off value of ≥0.6 ng/mL provided 73% sensitivity at 64% specificity for predicting sperm or spermatid retrieval in patients with non-obstructive azoospermia.ConclusionsWe demonstrated the clinical utility of TEX101 ELISA as a test to evaluate vasectomy success, to stratify azoospermia forms, and to better select patients for sperm retrieval.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0817-5) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…Rates varied for different histological subtypes of NOA: 81% for HS, 21% for MA, and 31% for SCO subtypes [28]. In our cohort of NOA samples with known histological subtypes and measured TEX101 (20 out of 26 samples in Fig.…”

Section: Resultsmentioning

confidence: 99%

Preclinical evaluation of a TEX101 protein ELISA test for the differential diagnosis of male infertility

Korbakis

Schiza

Brinc

et al. 2017

BMC Med

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“…Spermatogenic function of the testis needs to be suitable in various sex hormone parameters. Recent reports of the predictive factor of sperm retrieval investigated FSH, LH, inhibin‐B, and T . In many cases of high FSH levels, there is a high possibility that sperm retrieval will fail.…”

Section: Discussionmentioning

confidence: 99%

“…One effective technique for sperm retrieval that has been reported in a number of different studies is microdissection TESE (MD‐TESE), which is performed for NOA, and simple TESE that is performed for OA . According to recent reports, blood hormone levels, follicle‐stimulating hormone (FSH), luteinizing hormone (LH), inhibin‐B, testosterone (T), testicular volume, Y chromosome microdeletion, and chromosome inspection are used as predictors in sperm retrieval . After retrieval, one study reported a comparison between fresh and vitrified oocytes that were used in ICSI with fresh testicular sperm.…”

Section: Introductionmentioning

confidence: 99%

Long‐term clinical outcomes of testicular sperm extraction and intracytoplasmic sperm injection for infertile men

Okuyama

Obata

Oka

et al. 2017

Reprod Medicine & Biology

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PurposeTo find the best methods to achieve the highest pregnancy and birth rates for couples needing testicular sperm extraction (TESE)‐intracytoplasmic sperm injection (ICSI).MethodsRetrospectively studied were 801 patients with male factor infertility who had undergone TESE‐ICSI between April, 1996 and July, 2016 and who had been categorized into four groups: obstructive azoospermia (OA); non‐obstructive azoospermia (NOA); Klinefelter syndrome (KS); and cryptozoospermia (Crypt). The sperm retrieval rate, hormone levels, fertilization rate (FR), pregnancy rate (PR), and birth rate (BR) after ICSI among three groups were compared: fresh testicular sperm (FS)‐fresh oocytes (FO) (Group I); frozen‐thawed testicular sperm‐FO (Group II); and FS‐vitrified‐warmed oocytes (Group III).ResultsThe testicular sperm recovery rate was 57.8% (463/801): 89.6% in the Crypt, 97.1% in the OA, 28.9% in the NOA, and 42.2% in the KS groups. The follicle‐stimulating hormone levels were significantly higher in the NOA and KS groups and the testosterone levels were significantly lower in the KS group. The FR, PR, and BR were: 65.2%, 43.2%, and 28.5% in group I; 59.2%, 33.4%, and 18.7% in group II; and 56.4%, 33.8%, and 22.1% in group III.ConclusionIntracytoplasmic sperm injection with FS‐FO achieved the best PR and BR. It should be considered what to do in cases with no testicular sperm by TESE. The authors hope that ICSI with donor sperm will be allowed in Japan in the near future.

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“…A study found that sperm retrieval rates were positively related to increased testicular volume and decreased follicle stimulating hormone (FSH) levels in men with NOA (Ghalayini et al, ). In addition, one study found that testicular histology influenced sperm retrieval and fertilisation rates but not pregnancy or live birth rates for men with NOA undergoing ICSI (Guler et al, ).…”

Section: Introductionmentioning

confidence: 99%

Effects of obesity on sperm retrieval, early embryo quality and clinical outcomes in men with nonobstructive azoospermia undergoing testicular sperm aspiration‐intracytoplasmic sperm injection cycles

Yang

Shi

et al. 2019

Andrologia

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The objective of this study was to assess the effects of body mass index (BMI) on sperm retrieval, early embryo quality and clinical outcomes in patients with nonobstructive azoospermia (NOA) undergoing testicular sperm aspiration‐intracytoplasmic sperm injection (TESA‐ICSI). A total of 3,005 infertile couples were evaluated between January 2010 and June 2017, including 1585 normal‐weight (BMI < 25 kg/m2), 847 overweight (BMI 25–29.99 kg/m2) and 573 obese (BMI ≥ 30 kg/m2) patients. We found no significant relationship between BMI and sperm retrieval rate (22.4%, 24.3% and 25.1%, p = 0.327) or sperm motility. Among the 705 patients with NOA who underwent TESA‐ICSI cycles, obese individuals had lower T levels and higher E2 levels than normal‐weight and overweight individuals. However, there were no significant differences in other male hormones (follicle stimulating hormone [FSH], luteinizing hormone [LH], or prolactin [PRL]) among the groups. We also found that the sperm parameters, embryo quality and clinical outcomes of patients with NOA undergoing TESA‐ICSI were not influenced by high BMI levels. In conclusion, this study demonstrated a lack of obvious effects of obesity on sperm retrieval, early embryo quality and clinical outcomes in infertile men undergoing TESA‐ICSI cycles, although T and E2 levels were affected.

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Impact of testicular histopathology as a predictor of sperm retrieval and pregnancy outcome in patients with nonobstructive azoospermia: correlation with clinical and hormonal factors

Cited by 31 publications

References 35 publications

Preclinical evaluation of a TEX101 protein ELISA test for the differential diagnosis of male infertility

Preclinical evaluation of a TEX101 protein ELISA test for the differential diagnosis of male infertility

Long‐term clinical outcomes of testicular sperm extraction and intracytoplasmic sperm injection for infertile men

Effects of obesity on sperm retrieval, early embryo quality and clinical outcomes in men with nonobstructive azoospermia undergoing testicular sperm aspiration‐intracytoplasmic sperm injection cycles

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