Can Testicular Size Be a Predictive Factor for Successful Sperm Retrieval in Patients with Non Obstructive Azoospermia?

2019 ◽  
pp. 1
Author(s):  
Omer Yumusak ◽  
Mehmet Cinar ◽  
Serkan Kahyaoglu ◽  
Yasemin Tasci ◽  
Gul Nihal Buyuk ◽  
...  
Keyword(s):  
Follicle Stimulating Hormone ◽  
Significant Risk ◽  
High Serum ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Total Testosterone ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Stimulating Hormone

<p><strong>Objective:</strong> Non-obstructive azoospermia, defined as absence of spermatozoa in the ejaculate caused by impaired spermatogenesis, is the most severe cause of male infertility. It is typically presented as high serum follicle stimulating hormone levels and atrophic testis. The combination of intracytoplasmic sperm injection and Microdissection testicular sperm extraction allows these infertile men the opportunity to have their own children from their own testis. Our aim was to evaluate the outcomes of micro-Testicular sperm extraction in men with atrophic testis.</p><p><strong>Study Design:</strong> The medical records of 80 non-obstructive men with azoospermia who underwent micro-TESE were retrospectively evaluated. We assessed clinical parameters; age, duration of infertility, smoking, chromosomal karyotype, Y chromosome microdeletion, follicle stimulating hormone, luteinizing hormone, total testosterone and testicular volume in relation with Microdissection testicular sperm extraction results.</p><p><strong>Results:</strong> Testicular sperm retrieval rate was 53% in 80 patients. Testicular volume, serum follicle stimulating hormone and total testosterone concentrations showed correlation with the results of sperm retrieval. These three parameters were found to be significant risk factors with testicular sperm extraction negative patients (p&lt;0.001). The odds ratios (95% CI) were 6.39 (1.25–26.58), 1.24 (1.11-1.36), 1.13 (0.99-1.21) respectively. Testicular volume was found to be a discriminative parameter in patients with negative sperm retrieval. The cut-off point was established as 6.75 ml for testicular volume with 88.1% sensitivity, 62.1% specificity.</p><p><strong>Conclusion:</strong> Microdissection testicular sperm extraction is the most effective procedure for patients with non-obstructive azoospermia. Testicular volume, serum follicle stimulating hormone and testosterone levels can be predictive factors for sperm retrieval in men with non-obstructive azoospermia.</p>

Relevance of testicular histopathology on prediction of sperm retrieval rates in case of non-obstructive and obstructive azoospermia

2018 ◽  
Vol 85 (2) ◽  
pp. 60-67 ◽  
Author(s):  
Gianmartin Cito ◽  
Maria E Coccia ◽  
Sara Dabizzi ◽  
Simone Morselli ◽  
Pier A Della Camera ◽  
...  
Keyword(s):  
Follicle Stimulating Hormone ◽  
Needle Aspiration ◽  
Testicular Sperm Extraction ◽  
Total Testosterone ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Maturation Arrest ◽  
Fine Needle ◽  
Normal Spermatogenesis

Introduction: The aim of our research was to establish the relevance of testicular histopathology on sperm retrieval after testicular sperm extraction in patients with non-obstructive azoospermia and in patients with obstructive azoospermia, who already underwent a previous failure testicular fine needle aspiration. Methods: We evaluated a total of 82 azoospermic men, underwent testicular sperm extraction, referring to the Assisted Reproductive Technology Centre of the University of Florence, Italy between January 2008 and March 2017. A general and genital physical examination, scrotal and trans-rectal ultrasound, semen analysis, hormone measurements, including follicle-stimulating hormone, luteinizing hormone and total testosterone, were collected. Results: Successful sperm retrieval was obtained in 36 men of total (43.9%). Successful sperm retrieval was 29.5% in non-obstructive azoospermia patients, while men with obstructive azoospermia, who, underwent a previous failure testicular fine needle aspiration, had sperm retrieval in 86% of cases. Mean luteinizing hormone was 6.55 IU/L, total testosterone 4.70 ng/mL, right testicular volume 13.7 mL and left testicular volume 13.6 mL. Mean Follicle-stimulating hormone was 13.45 IU/L in patients with negative sperm retrieval and 8.18 IU/L in men with successful sperm retrieval. According to histology, 20.7% had normal spermatogenesis, 35.3% hypospermatogenesis, 35.3% maturation arrest and 8.5% Sertoli cell-only syndrome. Successful sperm retrieval was 88.2% in patients with normal spermatogenesis, 24.1% in the maturation arrest group and 48.27% in patients with hypospermatogenesis, while negative sperm retrieval was reported in Sertoli cell-only syndrome patients. Seven cases with maturation arrest showed a successful sperm retrieval. Conclusion: Testicular histopathology after testicular sperm extraction offers important information on prediction of sperm retrieval and can guide the surgeon in choosing the more suitable therapeutic practice.

Evaluation of neoadjuvant gonadotropin administration with downregulation by testosterone prior to second time microsurgical testicular sperm extraction: A prospective case–control study

2020 ◽  
Vol 87 (4) ◽  
pp. 185-190
Author(s):  
Medhat Kamel Amer ◽  
Hossam ElDin Hosni Ahmed ◽  
Sameh Fayek GamalEl Din ◽  
Ahmed Fawzy Megawer ◽  
Ahmed Ragab Ahmed
Keyword(s):  
Follicle Stimulating Hormone ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Hormone Levels ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Stimulating Hormone

Purpose: The aim of this prospective study was to determine whether there is a beneficial role of combining gonadotropin administration with testosterone downregulation in non-obstructive azoospermia patients prior to a second time microsurgical testicular sperm extraction after a negative one. Methods: A total of 40 non-obstructive azoospermia men were recruited from a specialized IVF center from 2014 to 2016. Participants were divided equally into two groups: Group A was subjected to testosterone downregulation alone for 1 month and then combined with gonadotropin administration for 3 months prior to second time testicular sperm extraction; Group B (controls) underwent second time microsurgical testicular sperm extraction without prior hormonal therapy. Results: Mean baseline follicle-stimulating hormone levels of the controls and the cases were 26.9 ± 11.8 and 25.4 ± 8.7, respectively. One month after testosterone downregulation, follicle-stimulating hormone level of the cases was normalized and became 2.4 ± 1.2. There was no statistically significant difference between baseline follicle-stimulating hormone levels of the controls and cases (p = 0.946). Remarkably, two cases were positive after downregulation (10%) and no controls were positive at second testicular sperm extraction (0%). There was no statistically significant difference between sperm retrieval after the second microsurgical testicular sperm extraction in the controls and the cases (p = 0.072). Conclusion: Patients who underwent first time testicular sperm extraction with unfavorable outcome due to different techniques may benefit from testosterone downregulation combined with neoadjuvant gonadotropin administration as it had shown positive sperms retrieval in 2 out of the 20 cases, especially those with hypergonadotropic azoospermia.

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

2021 ◽  
Author(s):  
Wei-Hsun Hsu ◽  
Marcelo Chen ◽  
Pai-Kai Chiang ◽  
Wei-Kung Tsai ◽  
Allen W Chiu ◽  
...  
Keyword(s):  
Sertoli Cell ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Retrieval Rate ◽  
Normal Spermatogenesis

Abstract The aim of the current study was to investigate the predictive markers for males with non-obstructive azoospermia (NOA) before they received conventional testicular sperm extraction (cTESE) or microdissection testicular sperm extraction (microTESE). Between January 2010 and December 2020, a total of 56 patients who received cTESE or microTESE surgery at the Urology department of the MacKay Memorial Hospital were included. Our univariate analysis revealed that the following parameters was associated with sperm retrieval: Follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testicular volume, histopathology of maturation arrest and Sertoli cell-only. The multivariate analysis showed that Sertoli cell-only was significantly less likely to harvest spermatozoa than normal spermatogenesis (OR = 0.03 (0.002-0.42); p = 0.01). A comparison of cTESE and microTESE revealed that the overall successful sperm retrieval rate was not significantly different between the two methods (74.1% vs. 58.6, p = 0.22). This study demonstrated that lower levels of FSH, LH and prolactin, and a higher testicular volume and better histopathology were associated with a higher sperm retrieval rate in the univariate analysis. In the multivariable analysis, only Sertoli cell-only syndrome appeared to have a significantly negative effect on the successful harvesting of sperm when compared with normal spermatogenesis.

scholarly journals Endocrine Tests and/or Testicular Volume Are Not Predictive of Successful Sperm Retrieval by Multiple Testicular Sperm Extraction in Non-Obstructive Azoospermia

2020 ◽  
Author(s):  
Minh Tam Le ◽  
Thanh Tam Thi Nguyen ◽  
Dac Nguyen Nguyen ◽  
Nhu Quynh Thi Tran ◽  
Quoc Huy Vu Nguyen
Keyword(s):  
Descriptive Analysis ◽  
Testicular Volume ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Sperm Aspiration ◽  
Significant Difference ◽  
Testicular Sperm Aspiration

Abstract Objectives: This study aimed to determine the role of pre-surgical markers in the prediction of sperm retrieval in infertile Vietnamese men with azoospermia. 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 multiple testicular sperm extraction in up to 3 locations until sperm were detected. Factorswere analyzed to determine the prediction of sperm retrieval.Results: The overall success rate of sperm retrieval was 49.3% including 88.3% and 18.4% in the OA and NOA group, respectively. The results of sperm retrieval were significantly associated only with the OA and NOA group, not with endocrine test or testicular volume. We found no significant difference in the endocrine test and testicular volume’s result between successful and unsuccessful sperm retrieval in either group.Conclusions: Neither an endocrine test nor testicular volume should be used for predicting the results of surgical sperm retrieval in infertile Vietnamese males with azoospermia.

scholarly journals Impact of age, follicle stimulating hormone and Johnsen’s score on successful sperm retrieval by microdissection testicular sperm extraction

2005 ◽  
Vol 4 (1) ◽  
pp. 53-57
Author(s):  
Akira Tsujimura ◽  
Yasushi Miyagawa ◽  
Tetsuya Takao ◽  
Kazutoshi Fujita ◽  
Kazuhiko Komori ◽  
...  
Keyword(s):  
Follicle Stimulating Hormone ◽  
Testicular Sperm Extraction ◽  
Testicular Sperm ◽  
Sperm Retrieval ◽  
Stimulating Hormone

scholarly journals Prognostic Factors for Successful Microdissection Testicular Sperm Extraction (Micro-TESE)

2021 ◽  
pp. 30-35
Author(s):  
Mohamed Hamdy Mashaly ◽  
Tarek Ahmed Gamil ◽  
Maged Moustafa Ragab ◽  
Mohamed Abo El-Enen Ghalwash
Keyword(s):  
Semen Analysis ◽  
Testicular Volume ◽  
Seminiferous Tubules ◽  
Testicular Sperm Extraction ◽  
Obstructive Azoospermia ◽  
Testicular Sperm ◽  
University Hospitals ◽  
Sperm Retrieval ◽  
Significant Difference ◽  
Detailed Medical History

Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the causes of infertility, these men need sperm retrieval from testes like microdissection testicular sperm extraction (Micro-TESE). This work aims to assess the different preoperative and intraoperative factors that predict successful sperm retrieval with Microdissection Testicular Sperm Extraction (Micro-TESE) in men with non-obstructive azoospermia. Methods: Our study is a cohort prospective one, conducted on 52 male patients with non-obstructive azoospermia who attended to the outpatient andrology and infertility clinic of Urology Department, Tanta University Hospitals during the period between December2018 to November2019. All patients were subjected to detailed medical history, physical examination, two semen analysis on two different laboratories. Microdissection Testicular Sperm Extraction is performed to all patients after Estimation of serum FSH, LH, testosterone, prolactin, estradiol and scrotal Doppler ultrasonography Results: From 52 patients who have done, Patients were divided in to 2 groups according to the result of Micro-TESE procedure: negative SSR group (28 patients) and positive SSR group (24 patients).In comparison between the two groups according to preoperative factors as age, FSH, LH, estradiol, testosterone, prolactin and testicular volume, there was no significant difference between these groups. On comparison of intraoperative size of seminiferous tubules in relation to results of Micro-TESE, we found that presence of large convoluted seminiferous tubules was statistically significant in prediction of successful sperm retrieval with Micro-TESE Conclusions: The chances of sperm retrieval in men with NOA by Micro-TESE are not related to preoperatively age, FSH, LH, testosterone, estradiol, prolactin and testicular volume. The detection of large seminiferous tubules intraoperatively is a good predictor for successful sperm retrieval with Micro-TESE as it was statistically significant.

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