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Predictors for successful sperm retrieval of salvage microdissection testicular sperm extraction ( TESE ) following failed TESE in nonobstructive azoospermia patients
Author(s) -
Xu Tao,
Peng Li,
Lin Xiangguo,
Li Jingjia,
Xu Wanhai
Publication year - 2017
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.12642
Subject(s) - sperm retrieval , testicular sperm extraction , azoospermia , microdissection , medicine , sperm , urology , gynecology , andrology , biology , infertility , pregnancy , biochemistry , genetics , gene
Summary The purpose of this study was to observe the clinical utility and the possible determinants in predicting sperm retrieval of salvage microdissection testicular sperm extraction ( mTESE ) for nonobstructive azoospermia ( NOA ) patients with failed conventional TESE at their first attempts. A total of 52 NOA males underwent salvage mTESE were recruited in this study. Related data, including age, BMI , the presence of Klinefelter's syndrome and varicocele, cryptorchidism, mean testicular volume, hormonal profile (total testosterone ( TT ), follicle‐stimulating hormone ( FSH ), luteinising hormone ( LH ), inhibin B ( INHB )), testicular histology and surgical duration, were collected and analysed. A multivariate logistic regression with likelihood ratio test revealed the following predictors of sperm retrieval: TT and testicular histology (chi‐square of likelihood ratio = 26.42, df = 4, p < .005). A formula was also established using multivariate regression analysis in predicting sperm retrieval probability. A predicted probability of more than 71% was determined of the formula as the cut‐off value in predicting sperm retrieval using receiver operating characteristics ( ROC ) analysis with a sensitivity and specificity 78.0% and 72.4% respectively. In conclusion, salvage mTESE is of clinical value in NOA males with failed TESE attempts, whereas the established formula could be useful in determining the proper salvage mTESE candidates.