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. 2025 Jan-Mar;18(1):38-44.
doi: 10.4103/jhrs.jhrs_9_25. Epub 2025 Mar 29.

The Predictive Value of Serum Follicle-stimulating Hormone Level and Testicular Volume on the Outcome of Spermatozoa Retrieval from Testes in Men with Non-obstructive Azoospermia - A Retrospective Cohort Study

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The Predictive Value of Serum Follicle-stimulating Hormone Level and Testicular Volume on the Outcome of Spermatozoa Retrieval from Testes in Men with Non-obstructive Azoospermia - A Retrospective Cohort Study

Puvithra Thanikachalam et al. J Hum Reprod Sci. 2025 Jan-Mar.

Abstract

Background: Biological parenthood in men with azoospermia can be achieved only by successful surgical spermatozoa retrieval and utilising these spermatozoa to perform intracytoplasmic spermatozoon injection. Spermatozoa retrieval from testes (SPERT) involves removing seminiferous tubules in an attempt to retrieve spermatozoa in men with non-obstructive azoospermia (NOA). Testicular volume and serum follicle-stimulating hormone (FSH) levels are considered to be markers for predicting the success of spermatozoa retrieval from the testes.

Aim: The aim of this study was to study the predictive value of serum FSH level and testicular volume on the outcome of SPERT in men with NOA.

Settings and design: It is a retrospective cohort study of 26 men with NOA who underwent SPERT from 2008 to 2024 in a university-level teaching hospital.

Materials and methods: The study population was divided into four groups based on the FSH levels (Group I: FSH: 2-10.9 mIU/mL [n = 10], Group II: FSH: 11-20.9 mIU/mL [n = 4], Group III: FSH: 21-30 mIU/mL [n = 8] and Group IV: FSH: >30 mIU/mL [n = 4]). A comparison of testicular volume and SPERT outcome was studied in the number of testes, in which SPERT was performed (n = 48) due to the differences in testicular volume in the same individual and also because only unilateral SPERT was performed in some patients. Patients were divided into three groups based on testicular volume (Group I: Testicular volume: 7-10 mL (n = 30), Group II: Testicular volume: 4-6 mL (n = 11) and Group III: Testicular volume: <3 mL (n = 7)].

Statistical analysis used: The collected data were analysed using Chi-square test using SPSS software.

Results: Our observations showed no correlation between successful SPERT and serum FSH levels or testicular volume. Based on the serum FSH level, the success rate of SPERT was 40%, 50%, 25% and 75% in Groups I, II, III and IV (P = 0.415). Similarly, based on the testicular volume groups, the success rates were 30%, 45% and 71% in Groups I, II and III (P = 0.118).

Conclusion: In this study, we found that neither serum FSH level nor testicular volume could predict the success of spermatozoa retrieval using the SPERT technique in men with NOA.

Keywords: Azoospermia; male infertility; non-obstructive azoospermia; surgical spermatozoa retrieval.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of study population based on serum follicle-stimulating hormone levels (original). FSH: Follicle-stimulating hormone
Figure 2
Figure 2
Distribution of study population based on testicular volume (original)

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