Predictive factors of successful testicular sperm extraction for non‐obstructive azoospermia with a history of bilateral cryptorchidism and normal testosterone

Abstract

This study aimed to assess the predictive factors of successful sperm retrieval in non‐obstructive azoospermia with a history of bilateral cryptorchidism. This retrospective study included 103 patients with azoospermia who had micro‐dissection testicular sperm extraction between January 2010 and January 2020. The median (range) age of the patients and their wives in the study group was 33 (21–44) and 24 (19–33) years, respectively. The patients with low testosterone level (<3 ng/dl) were prescribed with human chorionic gonadotropin 5,000 IU injection every 3 days for 3 months. Those with persistent low testosterone even after hormonal stimulation were excluded. Sperms were retrieved from 64 (62%) patients, whilst failed in 39 (38%) patients. On univariate analysis, the median testicular volume was significantly larger in the successful group versus the failed group (p < .001), serum FSH and serum LH were significantly lower in the successful group (p = .001), serum testosterone was significantly higher in the successful group compared to the failed group (p < .001) and the age of orchidopexy was lower in the successful group versus the failed group (p = .016). On multivariate analysis, the average testicular volume and the serum testosterone levels were independent factors for successful 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] .…”