Song Ming-Zhe, Ye Li-Jun, Xiao Wei-Qiang, Huang Wen-Si, Wen Wu-Biao, Dai Shun, Lai Li-Yun, Peng Yue-Qin, Wu Tong-Hua, Sun Qing, Zeng Yong, Cai Jing
Department of Urology, Shenzhen Zhongshan Obstetrics and Gynecology Hospital (Formerly Shenzhen Zhongshan Urology Hospital), Shenzhen 518045, China.
Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen Zhongshan Obstetrics and Gynecology Hospital (Formerly Shenzhen Zhongshan Urology Hospital), Shenzhen 518045, China.
Asian J Androl. 2025 May 1;27(3):440-446. doi: 10.4103/aja202493. Epub 2024 Dec 24.
To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l -1 vs 32.95 [18.56] IU l -1 , P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l -1 vs 25.59 [18.40] IU l -1 , P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01-1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71-0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.
为研究术前血清促卵泡生成素（FSH）水平对睾丸精子获取概率的影响，我们对不同睾丸体积（TV）的非梗阻性无精子症（NOA）男性进行了一项研究，这些男性接受了显微外科睾丸精子提取术（micro-TESE）。回顾性分析了2019年4月至2022年11月在深圳中山泌尿外科医院（现深圳中山妇产医院，中国深圳）首次接受micro-TESE的177例NOA患者。根据平均TV四分位数将受试者分为四组。比较各TV组中精子获取阳性和阴性亚组的血清激素水平。总体精子获取率为57.6%。当平均TV<5 ml时，精子获取阳性亚组的FSH水平（中位数[四分位间距]）高于阴性结果亚组（第一四分位数[Q1：TV<3 ml]：43.32[17.92]IU l-1 vs 32.95[18.56]IU l-1，P = 0.048；第二四分位数[Q2：3 ml≤TV<5 ml]：31.31[15.37]IU l-1 vs 25.59[18.40]IU l-1，P = 0.042）。血清FSH水平升高与平均TV<5 ml的NOA男性micro-TESE精子获取成功相关（调整后的优势比[OR]：每单位增加1.06；95%置信区间[CI]：1.01-1.11；P = 0.011）。在TV≥5 ml的男性中，较大的TV与较低的精子获取几率相关（调整后的OR：每增加1 ml为0.84；95%CI：0.71-0.98；P = 0.029）。总之，血清FSH水平升高与TV<5 ml的NOA男性micro-TESE中精子获取阳性相关。在TV≥5 ml的男性中，平均TV增加与较低的精子获取几率相关。
