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Review
. 2018 Jul 4;18(1):63.
doi: 10.1186/s12894-018-0379-7.

Testicular histopathology, semen analysis and FSH, predictive value of sperm retrieval: supportive counseling in case of reoperation after testicular sperm extraction (TESE)

Lucio Gnessi  1 , Filomena Scarselli  2 , Maria Giulia Minasi  2 , Stefania Mariani  3 , Carla Lubrano  3 , Sabrina Basciani  3 , Pier Francesco Greco  2 , Mikiko Watanabe  3 , Giorgio Franco  4 , Alessio Farcomeni  5 , Ermanno Greco  2
Affiliations
Review

Testicular histopathology, semen analysis and FSH, predictive value of sperm retrieval: supportive counseling in case of reoperation after testicular sperm extraction (TESE)

Lucio Gnessi et al. BMC Urol. .

Abstract

Background: To provide indicators for the likelihood of sperm retrieval in patients undergoing testicular sperm extraction is a major issue in the management of male infertility by TESE. The aim of our study was to determine the impact of different parameters, including testicular histopathology, on sperm retrieval in case of reoperation in patients undergoing testicular sperm extraction.

Methods: We retrospectively analyzed 486 patients who underwent sperm extraction for intracytoplasmic sperm injection and testicular biopsy. Histology was classified into: normal spermatogenesis; hypospermatogenesis (reduction in the number of normal spermatogenetic cells); maturation arrest (absence of the later stages of spermatogenesis); and Sertoli cell only (absence of germ cells). Semen analysis and serum FSH, LH and testosterone were measured.

Results: Four hundred thirty patients had non obstructive azoospermia, 53 severe oligozoospermia and 3 necrozoospermia. There were 307 (63%) successful sperm retrieval. Higher testicular volume, lower levels of FSH, and better histological features were predictive for sperm retrieval. The same parameters and younger age were predictive factors for shorter time for sperm recovery. After multivariable analysis, younger age, better semen parameters, better histological features and lower values of FSH remained predictive for shorter time for sperm retrieval while better semen and histology remained predictive factors for successful sperm retrieval. The predictive capacity of a score obtained by summing the points assigned for selected predictors (1 point for Sertoli cell only, 0.33 points for azoospermia, 0.004 points for each FSH mIU/ml) gave an area under the ROC curve of 0.843.

Conclusions: This model can help the practitioner with counseling infertile men by reliably predicting the chance of obtaining spermatozoa with testicular sperm extraction when a repeat attempt is planned.

Keywords: FSH; Semen; Sperm retrieval; Testicular biopsy; Testicular sperm extraction (TESE).

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Institutional Review Board of the European Hospital, Rome, Italy and conducted in compliance with the principles of the Declaration of Helsinki. The patients included have signed written informed consent to publication of their case details and acknowledged that the results of this study did not affect the subsequent clinical course.

Consent for publication

The written informed consent for publication of details including the statistics of clinical, biochemistry, pathological, and radiological informations, was obtained from all the patients included in this study.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
ROC curve of pertinent parameters to discriminate successful and failed cTESE (AUC = 0.843). ROC = Receiver operating characteristic; cTESE = conventional testicular sperm extraction; AUC = area under a curve
See this image and copyright information in PMC

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