World Scientific
  • Search
Skip main navigation

Cookies Notification

We use cookies on this site to enhance your user experience. By continuing to browse the site, you consent to the use of our cookies. Learn More
×
Our website is made possible by displaying certain online content using javascript.
In order to view the full content, please disable your ad blocker or whitelist our website www.worldscientific.com.

System Upgrade on Tue, Oct 25th, 2022 at 2am (EDT)

Existing users will be able to log into the site and access content. However, E-commerce and registration of new users may not be available for up to 12 hours.
For online purchase, please visit us again. Contact us at [email protected] for any enquiries.

Endocrine Tests and/or Testicular Volume are Not Predictive of Successful Sperm Retrieval by Conventional Multiple Testicular Sperm Extraction in Nonobstructive Azoospermia

    Objectives: This study aimed to determine the role of presurgical markers in the prediction of sperm retrieval by conventional Multiple Testicular Sperm Extraction in infertile Vietnamese men with nonobstructive azoospermia (NOA).

    Patients and Methods: Retrospective descriptive analysis of 136 infertile men with azoospermia, examined from August 2014 to July 2018. Patients underwent stepwise surgical sperm retrieval via percutaneous epididymal sperm aspiration, testicular sperm aspiration, then conventional multiple testicular sperm extraction in up to three locations, and procedures stopped as soon as sperm were detected. Factors were analyzed to determine the prediction of the likelihood of successful sperm retrieval, in men with NOA.

    Results: The overall success rate of sperm retrieval in men with azoospermia was 49.3%, but it was only 18.4% in NOA group. The difference in testicular volume between men with successful sperm retrieval and unsuccessful sperm retrieval was not statistically significant in NOA group (5.68 ± 2.37 vs. 4.46 ± 2.83, p = 0.138). The differences in the endocrine tests between the two groups were also not significant in terms of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone (p > 0.05). Multivariable analysis of predictive factors of sperm retrieval in NOA groups found no significant difference, except testicular density (p = 0.015).

    Conclusions: In infertile men with NOA, neither an endocrine test nor testicular volume should be used for predicting the results of surgical sperm retrieval by conventional multiple testicular sperm extraction.

    References

    • Aziz N. The importance of semen analysis in the context of azoospermia. Clinics (Sao Paulo). 2013; 68 :35–8. CrossrefGoogle Scholar
    • Boitrelle F, Robin G, Marcelli F et al., A predictive score for testicular sperm extraction quality and surgical ICSI outcome in non-obstructive azoospermia: a retrospective study. Hum Reprod. 2011; 26 :3215–21. CrossrefGoogle Scholar
    • Bryson CF, Ramasamy R, Sheehan M, Palermo GD, Rosenwaks Z, Schlegel PN. Severe testicular atrophy does not affect the success of microdissection testicular sperm extraction. J Urol. 2014; 191 :175–8. CrossrefGoogle Scholar
    • Chen SC, Hsieh JT, Ju HJ, Chang HC. Appropriate cut-off value for follicle-stimulating hormone in azoospermia to predict spermatogenesis. Reprod Biol Endocrinol. 2010; 8 :108. CrossrefGoogle Scholar
    • Cissen M, Meijerink AM, D’Hauwers KW et al., Prediction model for obtaining spermatozoa with testicular sperm extraction in men with non-obstructive azoospermia. Hum Reprod. 2016; 31 :1934–41. CrossrefGoogle Scholar
    • Deruyver Y, Vanderschueren D, Van der Aa F. Outcome of microdissection TESE compared with conventional TESE in non-obstructive azoospermia: a systematic review. Andrology. 2013; 2(1) :20–4. CrossrefGoogle Scholar
    • Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the Scrotum. Radiology. 2003; 227 :18–36. CrossrefGoogle Scholar
    • Enatsu N, Miyake H, Chiba K, Fujisawa M. Predictive factors of successful sperm retrieval on microdissection testicular sperm extraction in Japanese men. Reprod Med Biol. 2015; 15 :29–33. CrossrefGoogle Scholar
    • Esteves SC, Miyaoka R, Agarwal A. Sperm retrieval techniques for assisted reproduction. Int Braz J Urol. 2011; 7 :570–83. CrossrefGoogle Scholar
    • Flannigan R, Bach PV, Schlegel PN. Microdissection testicular sperm extraction. Transl Androl Urol. 2017; 6(4) :745–52. CrossrefGoogle Scholar
    • Gnessi L, Scarselli F, Minasi MG et al., Testicular histopathology, semen analysis and FSH, predictive value of sperm retrieval: supportive counseling in case of reoperation after testicular sperm extraction (TESE). BMC Urol. 2018; 18(1). CrossrefGoogle Scholar
    • Huang IS, Huang WJ, Kin AT. Distinguish non-obstructive azoospermia from obstructive azoospermia in Taiwanese patients by hormone profile and testis size. J Chin Med Assoc. 2018; 81 :531–5. CrossrefGoogle Scholar
    • Ishikawa T. Surgical recovery of sperm in non-obstructive azoospermia. Asian J Androl. 2012; 14 :109–15. CrossrefGoogle Scholar
    • Jarow JP, Coburn M, Sigman M. Incidence of varicoceles in men with primary and secondary infertility. Urology. 1996; 47 :73–6. CrossrefGoogle Scholar
    • Jungwirth A, Giwercman A, Tournaye H et al., European Association of Urology guidelines on Male Infertility: the 2012 update. Eur Urol. 2012; 62 :324–32. CrossrefGoogle Scholar
    • Kristo A, Dani E. The correlation between Ultrasound testicular volume and conventional semen parameters in Albanian subfertile males. Open Access Maced J Med Sci. 2014; 2 :464–6. CrossrefGoogle Scholar
    • Layman LC, McDonough PG. Mutations of follicle stimulating hormone-beta and its receptor in human and mouse: genotype/phenotype. Mol Cell Endocrinol. 2000; 161 :9–17. CrossrefGoogle Scholar
    • Layman LC, Porto AL, Xie J, DaMotta LA, Weiser W, Sluss PM. FSHβ gene mutations in a female with partial breast development and a male sibling with normal puberty and azoospermia. J Clin Endocrinol Metab. 2002; 87 :3702–7. Google Scholar
    • Levine LA, Dimitriou RJ, Fakouri B. Testicular and epididymal percutaneous sperm aspiration in men with either obstructive or non-obstructive azoospermia. Urology. 2003; 62 :328. CrossrefGoogle Scholar
    • Li H, Chen LP, Yang J et al., Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis. Asian J Androl. 2018; 20 :30–6. CrossrefGoogle Scholar
    • Matsumoto AM, Bremner WJ. Endocrinology of the hypothalamic-pituitary-testicular axis with particular reference to the hormonal control of spermatogenesis. Baillieres Clin Endocrinol Metab. 1987; 1 :71–87. CrossrefGoogle Scholar
    • Moon MH, Kim SH, Cho JY, Seo JT, Chun YK. Scrotal US for evaluation of infertile men with azoospermia. Radiology. 2006; 239 :168–73. CrossrefGoogle Scholar
    • Ramasamy R, Bryson C, Reifsnyder JE, Neri Q, Palermo GD, Schlegel PN. Overweight men with nonobstructive azoospermia have worse pregnancy outcomes after microdissection testicular sperm extraction. Fertil Steril. 2013; 99 :372–6. CrossrefGoogle Scholar
    • Ramasamy R, Trivedi NN, Reifsnyder JE, Palermo GD, Rosenwaks Z, Schlegel PN. Age does not adversely affect sperm retrieval in men undergoing microdissection testicular sperm extraction. Fertil Steril. 2014; 101 :653–5. CrossrefGoogle Scholar
    • Ramasamy R, Yagan N, Schlegel PN. Structural and functional changes to the testis after conventional versus microdissection testicular sperm extraction. Urology. 2005; 65; 1190–4. CrossrefGoogle Scholar
    • Sabanegh E, Agarwal A. Male infertility. In: Wein AKavousi L (editors). Campbell – Walsh Urology, Saunders, Elsevier; 2012, pp. 616–47. CrossrefGoogle Scholar
    • Sakamoto H, Saito K, Oohta M, Inoue K, Ogawa Y, Yoshida H. Testicular volume measurement: comparison of ultrasonography, orchidometry, and water displacement. Urology. 2007; 69 :152–7. CrossrefGoogle Scholar
    • Salehi P, Derakhshan-Horeh M, Nadeali Z et al., Factors influencing sperm retrieval following testicular sperm extraction in nonobstructive azoospermia patients. Clin Exp Reprod Med. 2017; 44 :22–7. CrossrefGoogle Scholar
    • Sarteschi LM. Lo studio del varicocele con eco-color-Doppler. G Ital Ultrasonologia. 1993; 4 :43–9. Google Scholar
    • Schoor RA, Elhanbly S, Niederberger CS, Ross LS. The role of testicular biopsy in the modern management of male infertility. J Urol. 2002; 167 :197–200. CrossrefGoogle Scholar
    • Schwarzer JU, Steinfatt H, Schleyer M, et al. Microdissection TESE is superior to conventional TESE in patients with nonobstructive azoospermia caused by Y chromosome microdeletions, 2015. Google Scholar
    • Setchell BP, Brooks DE. Anatomy, vasculature, innervation and fluids of the male reproductive ract. In: Knobil and Neill’s Physiology of Reproduction. 3rd ed. Elsevier; 2006. CrossrefGoogle Scholar
    • Sharath KC, Najafi M, Vineeth VS, Malini SS. Assessment of testicular volume in correlation with Spermiogram of Infertile males in South India. Adv Stud Biol. 2013; 5 :327–35. CrossrefGoogle Scholar
    • Tang WH, Jiang H, Ma LL et al., Correlation of testicular volume and reproductive hormone level with the result of testicular sperm aspiration in non-obstructive azoospermia patients. Nat J Androl. 2012; 18 :48–51. Google Scholar
    • World Health Organization (2010) In: Organization WH (editor). WHO Laboratory Manual for the Examination and Processing of Human Semen. Geneva: World Health Organization. Google Scholar
    • Wosnitzer MS, Goldstein M. Obstructive azoospermia. Urol Clin North Am. 2014; 41 :83–95. CrossrefGoogle Scholar
    • Yang Q, Huang YP, Wang HX et al., Follicle-stimulating hormone as a predictor for sperm retrieval rate in patients with nonobstructive azoospermia: a systematic review and meta-analysis. Asian J Androl. 2015; 17 :218–4. Google Scholar
    • Ziaee SA, Ezzatnegad M, Nowroozi M, Jamshidian H, Abdi H, Hosseini Moghaddam SM. Prediction of successful sperm retrieval in patients with nonobstructive azoospermia. Urol J. 2006 :392–6. Google Scholar