Evaluation of Prognostic Factors and Determinants in Surgical Sperm Retrieval Procedures in Azoospermic Patients

Spahović, H.; Göktolga, Ümit; Junuzović, Dželaludin; Göktaş, C.; Rama, Admir

doi:10.5455/medarh.2017.71.243-245

Cited by 8 publications

(9 citation statements)

References 12 publications

(13 reference statements)

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“…After a review of the abstracts of 43 articles, 29 articles were selected for employment within this meta-analysis. 12 – 15 , 17 – 41 Of the 29 studies, 9 studies contributed data on 1227 patients who received cTESE 12 , 13 , 15 , 17 , 19 , 22 , 24 , 30 , 32 and 20 studies contributed a total of 4760 patients who received mTESE 14 , 18 , 20 , 21 , 23 , 25 – 29 , 31 , 33 – 41 ( Figure 1 ).…”

Section: Methodsmentioning

confidence: 99%

An examination of predictive markers for successful sperm extraction procedures: a linear model and systematic review

Major

Edwards

Simpson

et al. 2022

Asian Journal of Andrology

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The authors performed a comprehensive review of current literature to create a model comparing commonly evaluated variables in male factor infertility, for example, follicle-stimulating hormone (FSH), testicular volume (TV), and testosterone (T), to better predict sperm retrieval rate (SRR). Twenty-nine studies were included, 9 with data on conventional testicular sperm extraction (cTESE) for a total of 1227 patients and 20 studies including data on microdissection testicular sperm extraction (mTESE) for a total of 4760 patients. A weighted-means value of SRR, FSH, T, and TV was created, and a weighted linear regression was then used to describe associations among SRR, type of procedure, FSH, T, and TV. In this study, weighted-means values demonstrated mTESE to be superior to cTESE with an SRR of 51.9% vs 40.1%. Multiple weighted linear regressions were created to describe associations among SRR, procedure type, FSH, T, and TV. The models showed that for every 1.19 mIU ml −1 increase in FSH, there would be a significant decrease in SRR by 1.0%. Seeking to create a more clinically relevant model, FSH values were then divided into normal, moderate elevation, and significant elevation categories (FSH <10 mIU ml −1 , 10–19 mIU ml −1 , and >20 mIU ml −1 , respectively). For an index patient undergoing cTESE, the retrieval rates would be 57.1%, 44.3%, and 31.2% for values normal, moderately elevated, and significantly elevated, respectively. In conclusion, in a large meta-analysis, mTESE was shown to be more successful than cTESE for sperm retrievals. FSH has an inverse relationship to SRR in retrieval techniques and can alone be predictive of cTESE SRR.

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Section: Methodsmentioning

confidence: 99%

An examination of predictive markers for successful sperm extraction procedures: a linear model and systematic review

Major

Edwards

Simpson

et al. 2022

Asian Journal of Andrology

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“…Similarly, Bonarriba et al [25] have introduced the cutoff point of 12.2 mIU/mL for serum FSH with sensitivity and specificity of 71% and 75%, respectively. Nevertheless, it is generally accepted that the serum FSH has a poor value for predicting the existence of sperm in the testes [27,28,30]. Indeed, cases with even serum FSH > 90 mIU/mL but positive TESE outcomes have been observed in previous studies [21].…”

Section: Follicle-stimulating Hormonementioning

confidence: 99%

Hormonal markers as noninvasive predictors of sperm retrieval in non-obstructive azoospermia

Zarezadeh

Fattahi

Nikanfar

et al. 2021

J Assist Reprod Genet

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Non-obstructive azoospermia (NOA) is one of the leading causes of male factor infertility, which results from impaired spermatogenesis. Currently, the sole feasible therapeutic option for men with NOA to father their biologic children is sperm retrieval by testicular sperm extraction (TESE) approaches followed by an intracytoplasmic sperm injection program. Nevertheless, the rate of sperm retrieval from NOA men following TESE has remained as low as 50%, leading to a significant number of unsuccessful TESE operations. Given that TESE is associated with multiple side effects, the prediction of TESE outcome preoperatively can abolish unnecessary operations and thereby prevent NOA patients from sustaining adverse side effects. As the process of spermatogenesis is under the regulation of hormones, the hormonal profile of serum and/or seminal plasma may contain useful information about spermatogenesis status and can potentially predict the chance of sperm retrieval from NOA patients. A large body of literature is available on the predictive capability of different serum and seminal plasma hormones such as FSH, LH, testosterone, inhibin B, AMH, estradiol, prolactin, and leptin in a stand-alone basis or combinational fashion with respect to the TESE outcome. The present review aimed to evaluate the potential of these hormonal markers as noninvasive predictors of sperm retrieval in men with NOA.

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“…Diğer yandan genetik ve kromozom analizleri, testis hacmi, AMH, FSH, LH, testosteron, prolaktin ve inhibin B seviyelerinin, microTESE sonuçlarıyla ilişkisinin araştırıldığı çalışmalarda tutarlı sonuçlar bulunamamıştır. Bundan dolayı histolojik paternin başarı sürecinde daha önemli bir belirleyici olduğu ileri sürülmüştür (14)(15)(16)(17)(18)(19)(20). Genel olarak mikroTESE işlemi sonucu nonobstrüktif azospermi olgularında sperm elde etme başarısının %41.4, hipospermatogeneziste %100, maturasyon arrestinde %40.3, germ hücre aplazisinde %19.5 olduğu bildirilmiştir.…”

Section: Nonobstrüktif Azospermi Etyolojisi Ve Tedavi Seçenekleriunclassified

Nonobstrüktif Azospermi Olgularında Yeni Yaklaşımlar

Ünal

Özer

2019

SDÜ Tıp Fakültesi Dergisi

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Azospermi semende hiç sperm bulunamaması durumudur. Obstrüktif ve nonobstrüktif olmak üzere iki kategoriye ayrılır. Azospermi tanısı alan hastalardan elde edilen spermatozoayla, ilk gebelik ICSI (intrasitoplazmik sperm enjeksiyonu) işlemiyle 1993 yılında oluşmuştur. Obstrüktif azospermi olgularında sperm bulma şansı daha yüksek olmasına karşın, erkek infertilitesinin en şiddetli formu olan nonobstrüktif azospermide ise bu oran yaklaşık olarak %40-50 aralığındadır. Yapılan mikroTESE (testiküler sperm ekstraksiyonu) işlemiyle testiste immatür germ hücreleri bulunursa ROSI (round spermatid enjeksiyonu) işlemi yapılır ya da in vitro kültürlerle bu hücreler farklılaştırılmaya çalışılır. Matür germ hücresi bulunamayan bir mikroTESE sonrasında, hormon replasmanı veya ilaç tedavileriyle spermatozoaların elde edilmesi hedeflenir. Son yıllara kadar testislerde varlıkları bilinen spermatogoniumlara (sperm kök hücresi) ek olarak, yeni keşfedilen VSEL (very small embriyonic-like stem cell) kök hücrelerinin gösterilmesi tedavi yönündeki umutları daha da artırmıştır. Bunlardan başka deneysel olarak, hücre kültürleri, seminifer tübül kültürleri, organ kültürleri, testiküler organoidler, gen tedavileri ve kök hücre bazlı tedavilerin etkinliği gösterilmiştir. İnsan üzerinde başlayan gen terapilerinde ve mezenkimal kök hücre çalışmalarında, önemli ilerlemeler olması nedeniyle yakın bir zamanda azospermi tedavisinde de önemli gelişmeler olacağı düşünülmektedir.

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Evaluation of Prognostic Factors and Determinants in Surgical Sperm Retrieval Procedures in Azoospermic Patients

Cited by 8 publications

References 12 publications

An examination of predictive markers for successful sperm extraction procedures: a linear model and systematic review

An examination of predictive markers for successful sperm extraction procedures: a linear model and systematic review

Hormonal markers as noninvasive predictors of sperm retrieval in non-obstructive azoospermia

Nonobstrüktif Azospermi Olgularında Yeni Yaklaşımlar

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