Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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

Puvithra Thanikachalam  1 , Gayatri Ravikuppan  2 , Sowbarnika Arunkumar  2 , Radha Pandiyan  3 , Pandiyan Natarajan  3
Affiliations

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.

PubMed Disclaimer

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)
See this image and copyright information in PMC

References

    1. Practice Committee of the American Society for Reproductive Medicine Electronic Address: asrm@asrmorg Management of nonobstructive azoospermia: A committee opinion. Fertil Steril. 2018;110:1239–45. - PubMed
    1. Banerjee K, Singla B, Agria K. Correlation of serum FSH and rate of testicular sperm retrieval in non-obstructive azoospermia. Indian J Endocrinol Metab. 2023;27:167–9. - PMC - PubMed
    1. Prior M, Stewart J, McEleny K, Dwyer AA, Quinton R. Fertility induction in hypogonadotropic hypogonadal men. Clin Endocrinol (Oxf) 2018;89:712–8. - PubMed
    1. Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. Fertil Steril. 2021;115:54–61. - PubMed
    1. Esteves SC. Microdissection TESE versus conventional TESE for men with nonobstructive azoospermia undergoing sperm retrieval. Int Braz J Urol. 2022;48:569–78. - PMC - PubMed

LinkOut - more resources