Predictive value of pre‐operative inflammation‐based prognostic scores (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in testicular sperm extraction: a pilot study

Abstract

To investigate the ability of some hematologic prognostic scores demonstrating inflammation in predicting sperm presence in testicular sperm extraction (TESE). We retrospectively investigated the medical data of 430 patients with the diagnosis of non-obstruc tive azoospermia (NOA) who had undergone TESE operation consecutively in our institution between the dates of January 2009 and February 2017. In all, 352 patients with the diagnosis of NOA, with bilaterally palpable vas deferens, who had undergone TESE for the first time, were included in the study. Patients with genetic anomalies, genital infection, history of surgery or vasectomy, chronic diseases, history of inflammatory, metabolic, rheumatologic, or malignant diseases, morbid obesity, with the diagnosis of clinical varicocele, or patients who had undergone TESE for the second time were excluded from the study. According to the results of TESE, the patients were divided into two groups as those with sperm retrieval and those without sperm retrieval. These groups were compared in terms of age, infertility duration, body mass index, hormone profile, hematologic parameters, neutrophil-to-lymphocyte ratio (NRL), monocyte-to-eosinophil ratio (MER), and platelet-to-lymphocyte ratio (PLR). The NLR and PLR levels were found to be significantly higher in patients without sperm retrieval at TESE compared to those with sperm retrieval. The logistic regression analysis showed NLR as an independent factor that showed the presence of spermatozoa at TESE (odds ratio: 4.786, %95 confidence interval: 2.667-8.589, p < 0.001). The area under the ROC curve (AUC) for the PLR was determined to be 0.574. As the calculated AUC value of the PLR was below 0.6, there was insufficient evidence determined at TESE to say that it was a reliable marker to indicate the presence of spermatozoa. The area of the MER value under the ROC curve was not statistically significant. It has been demonstrated that systemic inflammation negatively affects the probability of extracting spermatozoa in TESE and NLR is an independent factor indicating the presence of spermatozoa in TESE.

The role of inflammatory parameters (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in patients with Peyronie's disease

“…Likewise, our findings (Ventimiglia et al, 2018). Another study demonstrated that systemic inflammation negatively affects the possibility of sperm retrieval in TESE (Yucel et al, 2017).…”

“…Our study revealed a cutoff value of 1.8 (AUC 0.712, p < 0.001; sensitivity 61.1%; specificity 75.0%) discrimination of the phases of PD for the NLR. Various cutoff values have been found in different studies for NLR ranged between 1 and 5 (Nishida et al ., ; Yucel et al ., ; Ventimiglia et al ., ). Forget et al .…”

“…reported that NLR decreases as a function of increasing ED severity and NLR > 3 as the most informative cut‐off for identifying men with severe ED (Ventimiglia et al ., ). Another study demonstrated that systemic inflammation negatively affects the possibility of sperm retrieval in TESE (Yucel et al ., ).…”

“…Our study revealed a cutoff value of 1.8 (AUC 0.712, p < 0.001; sensitivity 61.1%; specificity 75.0%) discrimination of the phases of PD for the NLR. Various cutoff values have been found in different studies for NLR ranged between 1 and 5 (Nishida et al, 2017;Yucel et al, 2017;Ventimiglia et al, 2018). Forget et al have identified the normal range for NLR in an adult, non-geriatric, population in good health are between 0.78 and 3.53 (Forget et al, 2017).…”

Effect of seasonal variation on the success of micro-dissection testicular sperm extraction: A pilot study

“…According to the literature, the rate of sperm retrieval in patients with NOA undergoing mTESE is around 50% (Vloeberghs et al, ). The success of the operation depends on many factors (Yucel et al, ), including seasonal variations in numerous physical and psychological factors, including reproduction. This, in turn, has drawn attention to the relationship between seasonal variation and sperm quality.…”