title: Androgen decline in patients with nonobstructive azoospemia after microdissection testicular sperm extraction.
abstract: OBJECTIVE
  Microdissection testicular sperm extraction (TESE) is the ideal procedure for obtaining a high sperm retrieval rate. However, few studies of the postoperative endocrinologic course have been reported. We evaluated the endocrinologic course for 1 year after microdissection TESE and compared the results with the testicular histologic findings.
  
  
  METHODS
  A total of 69 patients with nonobstructive azoospermia who had undergone microdissection TESE were included. The overall sperm retrieval rate was 50.7%. The endocrinologic data were evaluated before and 3, 6, and 12 months after surgery.
  
  
  RESULTS
  The mean serum total testosterone level in patients with hypospermatogenesis decreased postoperatively and had recovered by 12 months (102%). The mean serum total testosterone level in patients with Klinefelter syndrome also decreased postoperatively but had recovered to only 50% of the baseline value at 12 months after microdissection TESE. At 12 months, the mean serum total testosterone level in patients with maturation arrest was 93.1% of the preoperative level and that in patients with Sertoli cell-only syndrome was 80.6% of the preoperative level. The preoperative serum luteinizing hormone and follicle-stimulating hormone in patients with Klinefelter syndrome was high and remained high after microdissection TESE. The mean serum luteinizing hormone and follicle-stimulating hormone levels in patients with hypospermatogenesis did not change, and those in patients with maturation arrest increased continuously after microdissection TESE. Finally, those in patients with Sertoli cell-only syndrome increased up to 6 months after surgery and decreased after that.
  
  
  CONCLUSIONS
  The results of our study indicate that long-term endocrinologic follow-up is necessary after microdissection TESE, particularly for patients with Klinefelter syndrome to detect hypogonadism.
authors: Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Shingo
authors: S
authors: Takada
authors: Akira
authors: A
authors: Tsujimura
authors: Tomohiro
authors: T
authors: Ueda
authors: Yasuhiro
authors: Y
authors: Matsuoka
authors: Tetsuya
authors: T
authors: Takao
authors: Yasushi
authors: Y
authors: Miyagawa
authors: Minoru
authors: M
authors: Koga
authors: Masami
authors: M
authors: Takeyama
authors: Yoshio
authors: Y
authors: Okamoto
authors: Kiyomi
authors: K
authors: Matsumiya
authors: Hideki
authors: H
authors: Fujioka
authors: Norio
authors: N
authors: Nonomura
authors: Akihiko
authors: A
authors: Okuyama
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood*; D053713:Azoospermia / Q000097:blood* / Q000209:etiology; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy*; D007713:Klinefelter Syndrome / Q000150:complications / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D042282:Microdissection; D054331:Sertoli Cell-Only Syndrome / Q000150:complications / Q000503:physiopathology; D020554:Sperm Injections, Intracytoplasmic; D013079:Sperm Maturation; D053625:Sperm Retrieval / Q000009:adverse effects; D013091:Spermatogenesis; D013739:Testosterone / Q000097:blood
chemical_list: D000728:Androgens; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone