Association of higher serum follicle-stimulating hormone levels with successful microdissection testicular sperm extraction outcomes in nonobstructive azoospermic men with reduced testicular volumes

• Published in: Asian journal of andrology Vol. 27; no. 3; pp. 440 - 446
• Main Authors: Song, Ming-Zhe, Ye, Li-Jun, Xiao, Wei-Qiang, Huang, Wen-Si, Wen, Wu-Biao, Dai, Shun, Lai, Li-Yun, Peng, Yue-Qin, Wu, Tong-Hua, Sun, Qing, Zeng, Yong, Cai, Jing
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 01.05.2025; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Edition: 2
• Subjects: Adult; Azoospermia - blood; Azoospermia - pathology; Azoospermia - surgery; Follicle Stimulating Hormone - blood; Follicle-stimulating hormone; Humans; Male; male infertility; Microdissection; nonobstructive azoospermia; Organ Size; Original; ORIGINAL ARTICLE; Retrospective Studies; Sperm; sperm retrieval; Sperm Retrieval - statistics & numerical data; Spermatozoa; testis; Testis - pathology; China; sperm retrieval; follicle-stimulating hormone; testis; male infertility; nonobstructive azoospermia
• ISSN: 1745-7262; 1008-682X; 1008-682X; 1745-7262
• DOI: 10.4103/aja202493

Abstract To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l−1 vs 32.95 [18.56] IU l−1, P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l−1 vs 25.59 [18.40] IU l−1, P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01-1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71-0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.