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Predictive Factors of Successful Sperm Retrieval in Azoospermia.
MedLine Citation:
PMID:  23062736     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Testicular sperm extraction with intracytoplasmic sperm injection is the standard treatment for azoospermia. The objective of this study is to identify predictive factors of successful sperm retrieval. MATERIALS AND METHODS: Between June 2003 and May 2011, we tried testicular sperm extraction (TESE) in 74 azoospermic patients in the Reproductive Medicine Unit of Son Espases Hospital (Palma de Mallorca). Serum follicle stimulating hormone (FSH) and inhibin B levels, testicular histology, genetic study, presence or not of cryptozoospermia and testicular volume were examined. RESULTS: Spermatozoa were successfully recovered in 47.2% of the total patients, in 36% of non-obstructive azoospermic patients and in 100% of obstructive azoospermic patients. Low inhibin B and high FSH were correlated to sperm retrieval failure. The cutoff points were determined using ROC curves that were 67 pg/mL for inhibin B and 12.2 mUI/mL for FSH. Spermatozoa were not successfully retrieved in any patient with Y microdeletions in AZFa,b regions. Spermatozoa were successfully retrieved in 100% of the patients with CFTR mutations. The highest sperm retrieval rate was for hypospermatogenesis, followed by maturation arrest and Sertoli-cell-only. Spermatozoa were successfully retrieved in all cryptozoospermic patients. Although using a non-significant test, there seems to be a correlation between higher testicular volume and a higher probability of successful sperm retrieval. CONCLUSIONS: Except for Y microdeletions in AZFa,b regions, there is no predictive factor of testicular sperm retrieval to rule out a patient for TESE. Lower inhibin B is more related to sperm retrieval failure than higher FSH. Sperm retrieval is possible for all cases of CFTR mutations but in any case of microdeletion Y in AZFa,b. The lack of germ cells is correlated with a high probability of sperm retrieval failure. The presence of cryptozoospermia is correlated with a high probability of sperm retrieval success. We do not find a statistically significant relation between testicular volume and successful sperm retrieval.
Authors:
C R Bonarriba; J P Burgués; V Vidaña; X Ruiz; P Pizá
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-9
Journal Detail:
Title:  Actas urologicas espanolas     Volume:  -     ISSN:  1699-7980     ISO Abbreviation:  Actas Urol Esp     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704993     Medline TA:  Actas Urol Esp     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.
Affiliation:
Unidad de Reproducción Humana, Servicio de Urología, Hospital Universitario Son Espases, Palma de Mallorca, España. Electronic address: carlorakso@hotmail.com.
Vernacular Title:
Factores predictivos de recuperación espermática en las azoospermias.
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