Predictive factors of successful sperm retrieval in men with nonobstructive azoospermia

D. Damian, S. Anei, L. acea, B. Marinescu

Abstract: Our aim was to evaluate the predictive value of noninvasive parameters that indicate successful sperm retrieval for ICSI (intracytoplasmic sperm injection) in men with nonobstructive azoospermia without a preoperative testicular biopsy, which is a relatively invasive examination. Were assessed 36 patients with nonobstructive azoospermia who underwent bilateral testicular biopsies. Factors that we assessed in relation with the biopsy results were: age, duration of infertility, surgical history, testicular volume, testicular consistency, serum follicle-stimulating hormone (FSH), and serum total testosterone. Sperm retrival through testicular sperm extraction (TESE) was successful on 16 patients (44%). Follicle-stimulating hormone, testosterone concentration, and the testicular volume were associated with the results of the sperm retrieval. Men with a high testicular volume and a low value of FSH had successful sperm retrieval. The cut-off point was established as 14,4 ml for testicular volume, 19,8 UI/L for serum FSH. The sensitivities and specificities were 75% and 65% for testicular volume, 62% and 85% for FSH. Although FSH, testosterone concentration, and the testicular volume cannot predict with maximum accuracy the presence of the spermatozoa at the level of the testicle in the case of patients with obstructive azoospermia, the association of these 3 parameters makes a more precise evaluation raising the chances of TESE to succeed.
Keywords: nonobstructive azoospermia, sperm retrieval, testicular biopsy, follicle-stimulating hormone, testicular volume