Predictive factors for sperm retrieval from males with azoospermia who are eligible for testicular sperm extraction (TESE)

Abstract

The aim of this study was to evaluate the predictive value of factors in infertile male patients to retrieve sperm from their testicles before they undergo testicular sperm extraction (TESE). In total, 64 males were enrolled in this study. Infertility was identified as obstructive azoospermia (OA); non-obstructive azoospermia (NOA); Klinefelter syndrome (KS); and cryptozoospermia (Crypt). Age, body mass index and concomitant conditions were noted. Testicular volumes, serum levels of Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), testosterone (T) and prolactin were investigated. Sperm retrieval after TESE was noted as positive or negative. Average age of the cases was 36.8 years. TESE success rate of testicular sperm retrieval rate was 50.0%. Majority of men (83.9%) had a 46, XY karyotype, minority had genetic anomalies, and 5 of were diagnosed with KSall were TESE-negative. There was no statistical difference in age, testicular volume, presence of varicocele and microcalcifications or hormonal levels in the TESE-positive and negative groups. Smoking as an independent variable was the only risk factor statistically showing (OR = 0.269; p = 0.045) prediction of negative sperm retrieval after the TESE procedure. None of the parameters investigated herein predicted successful TESE outcomes. However, in cases with negative TESE only smoking was identified as a predictive factor for negative sperm retrieval and was established as a risk factor.

Predictive Factors for Sperm Retrieval in Males With Non-obstructive Azoospermia

“…Complications such as hematoma, testicular brosis and testicular atrophy were less frequent in microTESE groups compared with cTESE groups 11 . The rates of hematoma and dehiscence were signi cantly different between the TESE-positive group and the TESE-negative group 2 . In the current study, the complication rate showed no signi cant difference between the cTESE and microTESE groups and there was also no signi cant difference in the subgroup histopathology analysis.…”

“…Yalcin Kizilkan et al found that a previous successful testicular biopsy and higher testicular volume were predictive parameters for microTESE patients 6 . One study reported no predictors of successful outcomes, whereas tobacco usage was a predictor factor for patients with a negative TESE 2 . Another recent study concluded that there were no de nite predictors for sperm retrieval, except for chromosome disease; however, Sertoli cell-only histopathology was associated with a reduced chance of harvesting spermatozoa 14 .…”

“…Azoospermia is de ned as the absence of sperm in the ejaculated semen, and it is found in 10-15% of infertile men 1 . The most common causes of male infertility include non-obstructive azoospermia (NOA) and obstructive azoospermia (OA), followed by azoospermia factor (AZF) microdeletion on the Y chromosome and Klinefelter syndrome 2 .…”

“…Parameters such as hormone level, age, testicular volume and chromosome pro le have been previously analyzed as predictors of the sperm retrieval rate, however different results have been reported 2,5,6 . The aim of this study was to investigate the predictive value of different factors for males with NOA before they received cTESE or microTESE.…”

Use of contrast enhanced ultrasound in testicular diseases: A comprehensive review

“…Unfortunately, sperm retrieval using conventional TESE has only proved to be successful in a subset of patients, approximately 50%, regardless of the cause of azoospermia (obstructive or nonobstructive). 39 , 82 , 83 , 84 Spermatogenesis is not equally distributed throughout the testis, and it would appear that sperm quality is better in areas with high tissue perfusion. 85 The high accuracy of CEUS in assessing blood perfusion and microvascular architecture of the testes may suggest that this technique could help increase the probability of sperm retrieval.…”