Department of Urology, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC 29425, USA.
Asian J Androl. 2023 Jan-Feb;25(1):38-42. doi: 10.4103/aja202221.
The authors performed a comprehensive review of current literature to create a model comparing commonly evaluated variables in male factor infertility, for example, follicle-stimulating hormone (FSH), testicular volume (TV), and testosterone (T), to better predict sperm retrieval rate (SRR). Twenty-nine studies were included, 9 with data on conventional testicular sperm extraction (cTESE) for a total of 1227 patients and 20 studies including data on microdissection testicular sperm extraction (mTESE) for a total of 4760 patients. A weighted-means value of SRR, FSH, T, and TV was created, and a weighted linear regression was then used to describe associations among SRR, type of procedure, FSH, T, and TV. In this study, weighted-means values demonstrated mTESE to be superior to cTESE with an SRR of 51.9% vs 40.1%. Multiple weighted linear regressions were created to describe associations among SRR, procedure type, FSH, T, and TV. The models showed that for every 1.19 mIU ml increase in FSH, there would be a significant decrease in SRR by 1.0%. Seeking to create a more clinically relevant model, FSH values were then divided into normal, moderate elevation, and significant elevation categories (FSH <10 mIU ml, 10-19 mIU ml, and >20 mIU ml, respectively). For an index patient undergoing cTESE, the retrieval rates would be 57.1%, 44.3%, and 31.2% for values normal, moderately elevated, and significantly elevated, respectively. In conclusion, in a large meta-analysis, mTESE was shown to be more successful than cTESE for sperm retrievals. FSH has an inverse relationship to SRR in retrieval techniques and can alone be predictive of cTESE SRR.
作者对当前文献进行了全面回顾，创建了一个模型，比较了男性因素不育症中常用的评估变量，例如卵泡刺激素（FSH）、睾丸体积（TV）和睾酮（T），以更好地预测精子提取率（SRR）。共纳入 29 项研究，其中 9 项研究为常规睾丸精子提取（cTESE），共 1227 例患者，20 项研究为微切割睾丸精子提取（mTESE），共 4760 例患者。创建了 SRR、FSH、T 和 TV 的加权平均值，然后使用加权线性回归来描述 SRR、手术类型、FSH、T 和 TV 之间的关系。在这项研究中，加权平均值表明 mTESE 优于 cTESE，SRR 分别为 51.9%和 40.1%。创建了多个加权线性回归来描述 SRR、手术类型、FSH、T 和 TV 之间的关系。模型表明，FSH 每增加 1.19 mIU/ml，SRR 就会显著下降 1.0%。为了创建更具临床相关性的模型，然后将 FSH 值分为正常、中度升高和显著升高（FSH<10 mIU/ml、10-19 mIU/ml 和>20 mIU/ml）。对于接受 cTESE 的指数患者，其回收率分别为 57.1%、44.3%和 31.2%，对应 FSH 值正常、中度升高和显著升高。总之，在一项大型荟萃分析中，mTESE 在精子提取方面比 cTESE 更成功。FSH 与提取技术中的 SRR 呈反比关系，并且可以单独预测 cTESE 的 SRR。
