Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia： a meta-analysis

• Published in: Asian journal of andrology Vol. 20; no. 1; pp. 30 - 36
• Main Authors: Li, Hao, Chen, Li-Ping, Yang, Jun, Li, Ming-Chao, Chen, Rui-Bao, Lan, Ru-Zhu, Wang, Shao-Gang, Liu, Ji-Hong, Wang, Tao
• Format: Journal Article
• Language: English
• Published: China Medknow Publications and Media Pvt. Ltd 01.01.2018; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Accuracy; Analysis; Follicle-stimulating hormone; Infertility; Meta-analysis; microdissection TESE; nonobstructive azoospermia; prediction; sperm retrieval rate; Original; Sperm; Spermatogenesis; Studies; 调查结果;组织病理;FSH;精子;阴囊;预兆;学说;检索
• ISSN: 1008-682X; 1745-7262; 1745-7262
• DOI: 10.4103/aja.aja_5_17

We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate （SRR） of microdissection testicular sperm extraction （TESE） in patients with nonobstructive azoospermia （NOA）. All relevant studies were searched in PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO. We chose three parameters to perform the meta-analysis： follicle-stimulating hormone （FSH）, testicular volume, and testicular histopathological findings which included three patterns： hypospermatogenesis （HS）, maturation arrest （MA）, and Sertoli-cell-only syndrome （SCOS）. If there was a threshold effect, only the area under the summary receiver operating characteristic curve （AUSROC） was calculated. Otherwise, the pooled sensitivity, specificity, positive likelihood ratio （PLR）, negative likelihood ratio （NLR）, and the diagnostic odds ratio （DOR） were also calculated. Twenty-one articles were included in our study finally. There was a threshold effect among studies investigating FSH and SCOS. The AUSROCs of FSH, testicular volume, HS, MA, and SCOS were 0.6119, 0.6389, 0.6758, 0.5535, and 0.2763, respectively. The DORs of testicular volume, HS, and MA were 1.98, 16.49, and 1.26, respectively. The sensitivities of them were 0.80, 0.30, and 0.27, while the specificities of them were 0.35, 0.98, and 0.76, respectively. The PLRs of them were 1.49, 10.63, and 1.15, respectively. And NLRs were 0.73, 0.72, and 0.95, respectively. All the investigated factors in our study had limited predictive value. However, the histopathological findings were helpful to some extent. Most patients with HS could get sperm by microdissection TESE.