Deng Chenyao, Mao Jiaming, Zhao Lianming, Liu Defeng, Lin Haocheng, Zhang Zhe, Yang Yuzhuo, Zhang Haitao, Hong Kai, Jiang Hui
Department of Urology, Peking University Third Hospital, Beijing, 100191, China.
Department of Andrology, Peking University Third Hospital, Beijing, 100191, China.
Basic Clin Androl. 2023 Aug 10;33(1):28. doi: 10.1186/s12610-023-00195-x.
Testicular sperm aspiration (TESA) is widely used in the diagnosis and management of nonobstructive azoospermia. However, its ability for predicting microdissection testicular sperm extraction in nonobstructive azoospermia (NOA) patients with AZFc deletion remains uncertain. To investigate whether TESA affected the sperm retrieval rate (SRR) in NOA patients with AZFc deletion, a retrospective analysis of the clinical data of NOA patients with AZFc deletion who underwent microdissection testicular sperm extraction (micro-TESE) was conducted. The effects of age, testicular volume, follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels, testosterone (T) levels and TESA on the SRR were analyzed in this group of patients.
A total of 181 individuals had their sperm successfully collected and underwent micro-TESE, with an SRR of 67.4%. The patients were separated into two groups based on their micro-TESE results (sperm acquisition and nonsperm acquisition), with no significant variations in age, testicular volume, FSH levels, LH levels, or T levels between the two groups. There was no significant difference in the SRR between any of the groups into which patients were classified based on reproductive hormone reference value ranges. Binary logistic regression was used to explore the absence of significant effects of age, testicular volume, FSH levels, LH levels, and T levels on sperm acquisition in patients undergoing micro-TESE. In the preoperative testicular diagnostic biopsy group, the sperm acquisition and nonsperm acquisition groups had SRRs of 90.1% and 65.1%, respectively. More significantly, there was no significant difference in the SRR between the negative preoperative testicular diagnostic biopsy group and the nonpreoperative testicular diagnostic biopsy group (65.1 vs. 63.8%, p = 0.855).
There is a high probability of successful sperm acquisition in the testis of men undergoing micro-TESE. In this group of patients, age, testicular volume, FSH levels, LH levels, and T levels may have little bearing on the micro-TESE outcome. In patients whose preoperative TESA revealed the absence of sperm, the probability of obtaining sperm by micro-TESE remained high (65.1%); negative TESA results appeared to not influence the SRR (63.8%) in patients undergoing micro-TESE.
睾丸精子抽吸术（TESA）广泛应用于非梗阻性无精子症的诊断和治疗。然而，其对预测非梗阻性无精子症（NOA）且存在AZFc缺失患者的显微切割睾丸精子提取术的能力仍不确定。为了研究TESA是否会影响存在AZFc缺失的NOA患者的精子获取率（SRR），对接受显微切割睾丸精子提取术（显微TESE）的存在AZFc缺失的NOA患者的临床数据进行了回顾性分析。分析了该组患者的年龄、睾丸体积、促卵泡生成素（FSH）水平、促黄体生成素（LH）水平、睾酮（T）水平以及TESA对SRR的影响。
共有181例患者成功采集精子并接受了显微TESE，精子获取率为67.4%。根据显微TESE结果（获取精子和未获取精子）将患者分为两组，两组之间的年龄、睾丸体积、FSH水平、LH水平或T水平无显著差异。根据生殖激素参考值范围对患者进行分类，各亚组之间的SRR无显著差异。采用二元逻辑回归分析年龄、睾丸体积、FSH水平、LH水平和T水平对接受显微TESE患者精子获取无显著影响。在术前睾丸诊断性活检组中，获取精子组和未获取精子组的SRR分别为90.1%和65.1%。更显著的是，术前睾丸诊断性活检阴性组和未进行术前睾丸诊断性活检组之间的SRR无显著差异（65.1%对63.8%，p = 0.855）。
接受显微TESE的男性睾丸中成功获取精子的可能性很高。在该组患者中，年龄、睾丸体积、FSH水平、LH水平和T水平可能对显微TESE结果影响不大。在术前TESA显示无精子的患者中，通过显微TESE获取精子的概率仍然很高（65.1%）；术前TESA结果为阴性似乎不影响接受显微TESE患者的SRR（63.8%）。
