Predictive factors of sperm retrieval in non-obstructive azoospermia using conventional Testicular Sperm Extraction (TESE) – A retrospective, single center study

ABSTRACT

@#Testicular sperm extraction (TESE) allows for the possibility of intracytoplasmic sperm injection(ICSI) to achieve fertility but is an invasive procedure, and failed testicular sperm extraction hasbrought significant emotional and financial consequences to couples.@*OBJECTIVE@#This study aims to determine the relationship of pre-operative work-up variables such asage, FSH, LH, total testosterone in the success or failure of TESE in patients by 2 urologists with non-obstructive azoospermia in St. Luke's Medical Center-Global City.@*MATERIALS AND METHODS@#This is a retrospective chart review of patients presenting with infertility,diagnosed to have non-obstructive azoospermia and underwent conventional TESE from 2012 to2016 at St. Luke's Medical Center-Global City. Patients were adult males presenting with infertilityundergoing conventional TESE, known to have non-obstructive azoospermia. TESE outcomes of 46patients with complete parametric laboratory exams warranted for this study were used for statisticalanalysis.@*RESULTS@#T-test results showed no sufficient evidence to conclude that there is significant difference inmean age (p-value = 0.509), mean LH (p-value = 0.549), mean FSH (p-value = 0.81), and totaltestosterone (p-value = 0.824) between patients who had successful and failed TESE. Fisher's exacttest showed that most patients (90.3%) who have successful TESE outcome have normal FSH values.Logistic regression results showed no sufficient evidence to conclude that there is significantrelationship between TESE outcome and age (p-value = 0.503), LH (p-value = 0.542), FSH (p-value= 0.098), and TT (p-value = 0.819). Patients with normal FSH values are 6.22 times more likely tohave successful TESE outcomes compared to patients with elevated FSH values. However, logisticregression results showed no sufficient evidence to conclude that there is significant relationshipbetween successful TESE outcome and normal LH values (OR = 2.0, p-value = 0.493).@*CONCLUSION@#The preoperative factors for predicting success and failure of sperm retrieval duringTESE, including total testosterone, FSH and LH levels, were examined in this study, may not fullygive an estimation of the chances of obtaining spermatozoa in patients with NOA. Accordingly, thecombination and simultaneous interpretation of the other factors not present in this study, such astesticular volume, histopathological patterns, and karyotyping, would likely help to provide a moreaccurate prediction of success and failure and subsequently help the clinician to pursue the appropriatemethods of treatment for these patients.