Predictive factors for successful testicular biopsy

Submitted: July 5, 2023
Accepted: July 31, 2023
Published: September 27, 2023
Abstract Views: 558
PDF: 301
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Introduction: Infertility, the inability to conceive, constitutes a major problem in modern societies. It affects 10 to 15 percent of couples in the United States. Evaluation of infertile men is usually complex and often demands a testicular biopsy. Materials and methods: We reviewed all azoospermic men submitted to testicular biopsy, in our center, during infertility investigation between January 2015 and December 2021. Results: A total of 117 patients with a mean age of 36.5 was considered. Biopsy was positive, as defined by the presence of viable spermatozoids by microscopy, in 48.7% of patients (n = 57). Patients were divided in two separate groups based on positive (PB) or negative biopsy (NB) and compared. PB-group had normal serum total testosterone levels and higher than NB-group (3.7 ng/mL vs. 2.85 ng/mL, p = 0.021), and normal serum FSH levels and lower than NB-group (6.0 mIU/mL vs. 16.0 mIU/mL, p < 0.001). The groups were similar concerning serum LH levels (3.9 mIU/mL vs. 6.3 mIU/mL, p = 0.343. Conclusions: Predicting outcomes of testicular biopsy is a difficult task. Our study found that men with normal testicular volume, normal levels of testosterone and FSH and those with type 1 diabetes mellitus had a higher probability of positive testicular biopsy.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Cerilli, L.A., W. Kuang, and D. Rogers, A practical approach to testicular biopsy interpretation for male infertility. Arch Pathol Lab Med, 2010. 134(8): p. 1197-204. DOI: https://doi.org/10.5858/2009-0379-RA.1
Meng, M.V., K.L. Greene, and P.J. Turek, Surgery or assisted reproduction? A decision analysis of treatment costs in male infertility. J Urol, 2005. 174(5): p. 1926-31; discussion 1931. DOI: https://doi.org/10.1097/01.ju.0000176736.74328.1a
Kim, M.J., et al., Molecular and cytogenetic studies of 101 infertile men with microdeletions of Y chromosome in 1,306 infertile Korean men. J Assist Reprod Genet, 2012. 29(6): p. 539-46. DOI: https://doi.org/10.1007/s10815-012-9748-4
Gudeloglu, A. and S.J. Parekattil, Update in the evaluation of the azoospermic male. Clinics (Sao Paulo), 2013. 68 Suppl 1: p. 27-34. DOI: https://doi.org/10.6061/clinics/2013(Sup01)04
Iammarrone, E., et al., Male infertility. Best Pract Res Clin Obstet Gynaecol, 2003. 17(2): p. 211-29. DOI: https://doi.org/10.1016/S1521-6934(02)00147-5
Hauser, R., et al., Comparison of efficacy of two techniques for testicular sperm retrieval in nonobstructive azoospermia: multifocal testicular sperm extraction versus multifocal testicular sperm aspiration. J Androl, 2006. 27(1): p. 28-33. DOI: https://doi.org/10.2164/jandrol.05055
Ishikawa, T., Surgical recovery of sperm in non-obstructive azoospermia. Asian J Androl, 2012. 14(1): p. 109-15. DOI: https://doi.org/10.1038/aja.2011.61
Botelho, F., et al., Predictive factors of a successful testicular biopsy and subsequent clinical pregnancy. Andrologia, 2012. 44(4): p. 237-42. DOI: https://doi.org/10.1111/j.1439-0272.2012.01276.x
Zarezadeh, R., et al., Hormonal markers as noninvasive predictors of sperm retrieval in non-obstructive azoospermia. J Assist Reprod Genet, 2021. 38(8): p. 2049-2059. DOI: https://doi.org/10.1007/s10815-021-02176-3
Minhas, S., et al., European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2021 Update on Male Infertility. Eur Urol, 2021. 80(5): p. 603-620. DOI: https://doi.org/10.1016/j.eururo.2021.08.014
Björndahl, L., J. Kirkman Brown, and o.E.B.M.o.t.W.L.M.f.t.E.a.P.o.H. Semen, The sixth edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen: ensuring quality and standardization in basic examination of human ejaculates. Fertil Steril, 2022. 117(2): p. 246-251. DOI: https://doi.org/10.1016/j.fertnstert.2021.12.012
Schoor, R.A., et al., The role of testicular biopsy in the modern management of male infertility. J Urol, 2002. 167(1): p. 197-200. DOI: https://doi.org/10.1016/S0022-5347(05)65411-0
Pesce, C.M., The testicular biopsy in the evaluation of male infertility. Semin Diagn Pathol, 1987. 4(4): p. 264-74.
Jashnani, K., et al., Fine-Needle Aspiration Cytology of the Testes for the Classification of Azoospermia and Its Value in the Assessment of Male Infertility. Acta Cytol, 2020. 64(3): p. 216-223. DOI: https://doi.org/10.1159/000502790
Chan, P.T. and P.N. Schlegel, Diagnostic and therapeutic testis biopsy. Curr Urol Rep, 2000. 1(4): p. 266-72. DOI: https://doi.org/10.1007/s11934-000-0006-4
Kavoussi, P.K., et al., A comprehensive assessment of predictors of fertility outcomes in men with non-obstructive azoospermia undergoing microdissection testicular sperm extraction. Reprod Biol Endocrinol, 2020. 18(1): p. 90. DOI: https://doi.org/10.1186/s12958-020-00646-4
Ficarra, V., et al., Varicocele repair for infertility: what is the evidence? Curr Opin Urol, 2012. 22(6): p. 489-94. DOI: https://doi.org/10.1097/MOU.0b013e328358e115
Cho, C.L., S.C. Esteves, and A. Agarwal, Indications and outcomes of varicocele repair. Panminerva Med, 2019. 61(2): p. 152-163. DOI: https://doi.org/10.23736/S0031-0808.18.03528-0
Abdel-Meguid, T.A., Predictors of sperm recovery and azoospermia relapse in men with nonobstructive azoospermia after varicocele repair. J Urol, 2012. 187(1): p. 222-6. DOI: https://doi.org/10.1016/j.juro.2011.09.047
Ziaee, S.A., et al., Prediction of successful sperm retrieval in patients with nonobstructive azoospermia. Urol J, 2006. 3(2): p. 92-6.
Li, H., et al., Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis. Asian J Androl, 2018. 20(1): p. 30-36. DOI: https://doi.org/10.4103/aja.aja_5_17
Silber, S.J., et al., Normal pregnancies resulting from testicular sperm extraction and intracytoplasmic sperm injection for azoospermia due to maturation arrest. Fertil Steril, 1996. 66(1): p. 110-7. DOI: https://doi.org/10.1016/S0015-0282(16)58396-4
Ramasamy, R., et al., High serum FSH levels in men with nonobstructive azoospermia does not affect success of microdissection testicular sperm extraction. Fertil Steril, 2009. 92(2): p. 590-3. DOI: https://doi.org/10.1016/j.fertnstert.2008.07.1703
Tsujimura, A., et al., Prediction of successful outcome of microdissection testicular sperm extraction in men with idiopathic nonobstructive azoospermia. J Urol, 2004. 172(5 Pt 1): p. 1944-7. DOI: https://doi.org/10.1097/01.ju.0000142885.20116.60
O'Neill, J., et al., Differences in mouse models of diabetes mellitus in studies of male reproduction. Int J Androl, 2010. 33(5): p. 709-16. DOI: https://doi.org/10.1111/j.1365-2605.2009.01013.x
La Vignera, S., et al., Diabetes mellitus and sperm parameters. J Androl, 2012. 33(2): p. 145-53. DOI: https://doi.org/10.2164/jandrol.111.013193
Mallidis, C., et al., [The influence of diabetes mellitus on male reproductive function: a poorly investigated aspect of male infertility]. Urologe A, 2011. 50(1): p. 33-7. DOI: https://doi.org/10.1007/s00120-010-2440-3
Boeri, L., et al., Undiagnosed prediabetes is highly prevalent in primary infertile men - results from a cross-sectional study. BJU Int, 2019. 123(6): p. 1070-1077. DOI: https://doi.org/10.1111/bju.14558
Liu, X., et al., Effects of testicular sperm aspiration upon first cycle ICSI-ET for type 2 diabetic male patients. Syst Biol Reprod Med, 2020. 66(6): p. 355-363. DOI: https://doi.org/10.1080/19396368.2020.1785042
Craig, J.R., et al., Obesity, male infertility, and the sperm epigenome. Fertil Steril, 2017. 107(4): p. 848-859. DOI: https://doi.org/10.1016/j.fertnstert.2017.02.115
Leisegang, K., et al., Obesity and male infertility: Mechanisms and management. Andrologia, 2021. 53(1): p. e13617. DOI: https://doi.org/10.1111/and.13617
Leisegang, K., R. Henkel, and A. Agarwal, Obesity and metabolic syndrome associated with systemic inflammation and the impact on the male reproductive system. Am J Reprod Immunol, 2019. 82(5): p. e13178. DOI: https://doi.org/10.1111/aji.13178
Reis, L.O. and F.G. Dias, Male fertility, obesity, and bariatric surgery. Reprod Sci, 2012. 19(8): p. 778-85. DOI: https://doi.org/10.1177/1933719112440053
Hammoud, A.O., et al., Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril, 2008. 90(4): p. 897-904. DOI: https://doi.org/10.1016/j.fertnstert.2008.08.026

How to Cite

Brito, D. V., Lopes, M., Pereira, J., Ferreira, A. M., Sousa, L., Parada, B., & Figueiredo, A. (2023). Predictive factors for successful testicular biopsy. Archivio Italiano Di Urologia E Andrologia, 95(3). https://doi.org/10.4081/aiua.2023.11567