Prognostic factors for sperm retrieval in non-obstructive azoospermia

Abstract

Testicular sperm retrieval techniques associated with intracytoplasmic sperm injection have changed the field of male infertility treatment and given many azoospermic men the chance to become biological fathers. Despite the current use of testicular sperm extraction, reliable clinical and laboratory prognostic factors of sperm recovery are still absent. The objective of this article was to review the prognostic factors and clinical use of sperm retrieval for men with non-obstructive azoospermia.The PubMed database was searched for the Medical Subject Headings (MeSH) terms azoospermia, sperm retrieval, and prognosis. Papers on obstructive azoospermia were excluded. The authors selected articles that reported successful sperm retrieval techniques involving clinical, laboratory, or parenchyma processing methods. The selected papers were reviewed, and the prognostic factors were discussed.No reliable positive prognostic factors guarantee sperm recovery for patients with non-obstructive azoospermia. The only negative prognostic factor is the presence of AZFa and AZFb microdeletions.

Microdissection testicular sperm extraction for men undergoing cancer treatment

“…This may be a reflection of the testicular histological patterns of hypospermatogenesis and maturation arrest that are more frequently seen in these groups, and are associated with higher sperm retrieval rates 39 . In keeping with this, all patients with post chemotherapy azoospermia and evidence of hypospermatogenesis on testicular biopsy had successful sperm retrieval.…”

Multiple needle‐pass percutaneous testicular sperm aspiration as first‐line treatment in azoospermic men

“…Other proposed predictors of sperm retrieval success include FSH, testosterone, testis size, and inhibin B and although they provide some prognostic information none of them have been found to safely predict the success of mTESE or other sperm retrieval techniques (Glina & Vieira, 2013). The lack of accurate predictors would encourage the use of a prognostic approach to avoid unavailability of spermatozoa when ICSI is to be performed on collected oocytes.…”

“…Histopathology is one among many parameters that have been suggested as a method to predict outcomes of sperm retrieval (Glina & Vieira, 2013). However, in a number of studies on mTESE a biopsy for histology is only obtained during the surgical sperm retrieval thereby excluding the prognostic value of histopathological diagnosis (Tsujimura et al, 2002;Ramasamy et al, 2005;Turunc et al, 2010;Ghalayini et al, 2011).…”

Prospective Study of Predictive Factors and Outcome in Sperm Retrieval of Azoospermic Males: Initial Experience in Tertiary Care Centre

“…Similar results are found in many international studies. (15,17,18,19) . The predictive power of serum FSH for successful sperm retrieval is also analysed.…”

“…(10,11) The sperm recovery rates ranges from 90% to 100% for obstructive azoospermia using any of standard surgical technique (12) , but the sperm recovery rates for non-obstructive azoospermia range from 30-63% for TESE, and 43-63% for Micro-TESE; the rate for TEFNA is approximately 47%. (17) Out of all patients of azoospermia approximately 36% are due to obstructive azoospermia. (12) Thus on an average overall surgical success rate for sperm retrieval ranges between 50% to 70%.…”