Predictive factors for successful testicular biopsy

Submitted: July 5, 2023
Accepted: July 31, 2023
Published: September 27, 2023
Abstract Views: 570
PDF: 303
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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.

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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