Department of Biochemistry and Clinical Laboratories, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
J Assist Reprod Genet. 2021 Aug;38(8):2049-2059. doi: 10.1007/s10815-021-02176-3. Epub 2021 Mar 31.
Non-obstructive azoospermia (NOA) is one of the leading causes of male factor infertility, which results from impaired spermatogenesis. Currently, the sole feasible therapeutic option for men with NOA to father their biologic children is sperm retrieval by testicular sperm extraction (TESE) approaches followed by an intracytoplasmic sperm injection program. Nevertheless, the rate of sperm retrieval from NOA men following TESE has remained as low as 50%, leading to a significant number of unsuccessful TESE operations. Given that TESE is associated with multiple side effects, the prediction of TESE outcome preoperatively can abolish unnecessary operations and thereby prevent NOA patients from sustaining adverse side effects. As the process of spermatogenesis is under the regulation of hormones, the hormonal profile of serum and/or seminal plasma may contain useful information about spermatogenesis status and can potentially predict the chance of sperm retrieval from NOA patients. A large body of literature is available on the predictive capability of different serum and seminal plasma hormones such as FSH, LH, testosterone, inhibin B, AMH, estradiol, prolactin, and leptin in a stand-alone basis or combinational fashion with respect to the TESE outcome. The present review aimed to evaluate the potential of these hormonal markers as noninvasive predictors of sperm retrieval in men with NOA.
非阻塞性无精子症（NOA）是男性因素不孕的主要原因之一，其原因是精子发生受损。目前，NOA 男性生育亲生子女的唯一可行治疗选择是通过睾丸精子提取（TESE）方法进行精子提取，然后进行胞浆内精子注射计划。然而，TESE 后从 NOA 男性中提取精子的成功率仍然低至 50%，导致大量 TESE 手术失败。鉴于 TESE 与多种副作用相关，术前 TESE 结果的预测可以消除不必要的手术，从而防止 NOA 患者遭受不良反应。由于精子发生过程受到激素的调节，血清和/或精液中的激素谱可能包含有关精子发生状态的有用信息，并可能潜在预测从 NOA 患者中提取精子的机会。大量文献可用于研究不同的血清和精液激素，如 FSH、LH、睾酮、抑制素 B、AMH、雌二醇、催乳素和瘦素，单独或组合使用，以评估其对 TESE 结果的预测能力。本综述旨在评估这些激素标志物作为非侵入性预测因子在预测 NOA 男性精子提取中的潜力。
