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Predictive Factors of Sperm Recovery After Testicular Biopsy Among Non-Obstructive Azoospermic Patients

par Pening, David ;Devreker, Fabienne ;Delbaere, Anne
Référence ACOG 62nd Annual Clinical Meeting(Chicago), Predictive Factors of Sperm Recovery After Testicular Biopsy Among Non-Obstructive Azoospermic Patients, Obstetrics and gynecology, Vol. 123 (123), 5
Publication Publié, 2014-05-01

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Résumé :

INTRODUCTION: Azoospermia accounts for about 10% of male infertility. Sperm recovery can be performed by testicular biopsy and further IVF with ICSI is mandatory in order to obtain a pregnancy. While testicular sperm recovery is successful in almost all cases of obstructive azoospermia, the recovery rate varies from 30 to 70% for non-obstructive azoospermia. The aim of our study was to analyze the sperm recovery rate at testicular biopsy among non-obstructive azoospermic patients.METHODS: A retrospective cohort study of 143 nonobstructive azoospermic patients undergoing a testicular biopsy was led at the Erasme Hospital from 1st January 2002 to 31st December 2012. In order to identify predictive factors of a successful testicular sperm extraction, the following items were analyzed : biometric (age, height, weight), hormonal (follicule stimulating hormone [FSH], luteinizing hormone [LH], testosterone), genetic (karyotype abnormalities), anatomic (testicular volume) and histological data.RESULTS: One hundred forty-six testicular biopsies were performed on 143 men with non-obstructive azoospermia. The recovery rate of a successful testicular sperm extraction was 36%. Among genetic abnormalities, 8% had a Klinefelter syndrome (unsuccessful sperm recovery in 80%) and 9% had a Y microdeletion (unsuccessful recovery in all cases). The testicular volume was non-predictive of a sperm recovery. There was a correlation between the biologist and anatomopathologist for a successful recovery in 63%. NOA patients with an unsuccessful testicular biopsy had a mean FSH higher (P= 0.01) and a mean LH higher (P= 0.02) than those with a successful recovery.CONCLUSIONS: In non-obstructive azoospermia patients, the mean levels of LH and FSH were statistically higher in case of an unsuccessful testicular biopsy. However, at present, no clinical or biological factor studied can predict alone the outcome of a testicular biopsy in azoospermic men.