Parameters predicting sperm retrieval rates during microscopic testicular sperm extraction in nonobstructive azoospermia

Abstract

The aim of this study was to investigate the predictive value of the parameters that might have an effect on the success of microscopic testicular sperm extraction (micro-TESE) in infertile patients with nonobstructive azoospermia (NOA). Between 2003 and 2014, 860 patients with NOA were retrospectively analysed. The effect of age, infertility duration, history of varicocelectomy, herniorrhaphy or orchiopexy, presence of solitary testis, tobacco use, previous testicular biopsy results, history of orchitis, usage of human chorionic gonadotropin in the past three months, presence of undescended or retractile testis, presence of varicocele, testicular volume, levels of serum follicle-stimulating hormone, luteinising hormone, and testosterone, presence of Klinefelter syndrome and micro-deletion of Y chromosome on sperm retrieval rates were evaluated. In 45.8% (n = 394) of the patients who underwent micro-TESE, spermatozoon was adequately obtained. Multiple logistic regression analysis demonstrated that previous successful testicular biopsy (OR = 15.346;; p < .001) and higher testicular volumes significantly increase sperm retrieval rate in micro-TESE. The testicular volume cut-off as 11 ml was found to be the most significant factor. Although currently testicular biopsy result is not being used as a diagnostic method, it is significantly associated with micro-TESE result.

The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis

“… Articles Characteristics Mean Age (years, male/female) Varicocele Grade Varicocele Repair Methods Semen Analysis Pregnancy Modality Surgical Sperm Retrieval Method Kizilkan Y, et al. (2019) [ 11 ] 34.4/NR NR NR Azoospermia NR Micro-TESE Zampieri N, et al. (2013) [ 12 ] 33.1/NR Grade III Subinguinal microsurgery Azoospermia ICSI TESE Haydardedeoglu B, et al.…”

Hormonal Treatment of Men with Nonobstructive Azoospermia: What Does the Evidence Suggest?

“…The situation is quite different for the predictive role of serum T on the chances of sperm retrieval, since studies in the field have reported conflicting results. We were able to individuate 14 studies [29][30][31][32][33][34][35][36][37][38][39][40][41][42] who clearly reported the relationship between serum T levels and sperm retrieval rates (SRR) (Table 1). Studies differed for study design, inclusion criteria, and patients' characteristics.…”

Successful testicular sperm extraction in infertile male with non-obstructive azoospermia presented with bilateral atrophic testis: A case report

“…mTESE is considered to be the gold standard surgical procedure for sperm retrieval in NOA patients. 3 Studies documented that mTESE is 1.5-fold more effective than random multiple-biopsy TESE, which is 2-fold more effective than testicular aspiration. There are some indicators that might be predictive for successful SR, one of them is testicular size.…”

“… 5 Kizilkan et al study showed higher testicular volumes were found to increase sperm retrieval in mTESE, and volumes above 11 ml were significantly associated with successful results. 3 Marconi et al reported that men with a testicular volume of less than 8 ml and FSH greater than 12.4 IU had an approximately 30% chance of testicular SR by mTESE. In a study of 106 men.…”

“…mTESE was first described by Schlegel in 1999 as an advanced microsurgical treatment to retrieve sperm from men with NOA. 3 Several factors have been evaluated and reported for predicting sperm retrieval (SR) rates, including FSH and testicular volume. Men with NOA usually have smaller testicles.…”