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Can spermatozoa be retrieved in non‐obstructive azoospermic patients with high FSH level?: A retrospective cohort study
Author(s) -
Amer Medhat Kamel,
Ahmed Ahmed Ragab,
Abdel Hamid Asmaa Ahmed,
GamalEl Din Sameh Fayek
Publication year - 2019
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.13176
Subject(s) - sperm retrieval , histopathology , medicine , testicular sperm extraction , infertility , retrospective cohort study , statistical significance , gynecology , andrology , sperm , urology , spermatogenesis , azoospermia , male infertility , biology , pathology , pregnancy , genetics
We aimed in this retrospective study to evaluate non‐surgical preoperative parameters and testicular histopathology in determining the sperm retrieval rate (SRR) in non‐obstructive azoospermic (NOA) patients. We evaluated the data of 1,395 consecutive patients who underwent 1st time micro‐dissection testicular sperm extraction (micro‐TESE) that was done by fifteen different senior andrologists and a consequent undefined number of biologists assisting them in the operative rooms from January 2010 to May 2013 in a specialised IVF centre. Our study did not demonstrate any statistical significance between the mean age, the mean duration of infertility and finally, the mean of FSH levels of the patients with positive and negative micro‐TESE outcomes ( p ‐value 0.391, 0.543, 0.767 respectively). Moreover, our study did not demonstrate any association between different types of hormonal therapy prior to micro‐TESE and patients with positive micro‐TESE outcome ( p ‐value 0.219). Interestingly, our study showed positive associations between the testicular histopathology SCO (sertoli cell only syndrome) and high FSH and sperm retrieval rate ( p < 0.001, 0.02 respectively). Logistic regression analysis revealed high statistical significance between sperm retrieval rate and high FSH level and testicular histopathology (OR 1.6, 0.21, 95% CI lower 1.2, 0.008 and upper 2.1, 0.06 and finally p 0.003, <0.001 respectively). This study reveals that preoperative testicular biopsy is unnecessary to predict the sperm retrieval rate in NOA patients.