Appropriate cut-off value for follicle-stimulating hormone in azoospermia to predict spermatogenesis.
BACKGROUND
This study was undertaken to determine the optimal cut-off value for FSH to predict the presence of spermatogenesis in patients with non-obstructive azoospermia.


METHODS
A total of 206 non-obstructive azoospermic men were enrolled in this prospective study. By using receiver operating characteristic (ROC) curves, we determined the optimal cut-off value for FSH and evaluated whether the test could adequately predict successful sperm retrieval.


RESULTS
There were 108 non-obstructive azoospermic patients who had evidence of spermatogenesis (group A) and achieved success in sperm retrieval. Another 98 non-obstructive azoospermic patients (group B) failed in sperm retrieval. The mean value of serum FSH in group B was significantly higher than in group A (28.03 +/- 14.56 mIU/mL vs 7.94 +/- 4.95 mIU/mL, p < 0.01; respectively). The area under the receiver operating characteristic curves were 0.939 +/- 0.02 and a cut-off value of 19.4 mIU/mL discriminated between group A and B with a sensitivity of 70%. The positive predictive value for failed sperm retrieval (group B) can reach 100%.


CONCLUSIONS
Elevated plasma levels of FSH of more than 19.4 mIU/mL could be used as a reliable criterion for a trial of sperm retrieval from testes in artificial reproductive techniques.
Chen
Shyh-Chyan
SC
Department of Urology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Hsieh
Ju-Ton
JT
Yu
Hong-Jeng
HJ
Chang
Hong-Chiang
HC
D000328:Adult; D019540:Area Under Curve; D053713:Azoospermia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D003940:Diagnostic Techniques, Endocrine / Q000592:standards*; D005640:Follicle Stimulating Hormone / Q000097:blood* / Q000592:standards; D006801:Humans; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D012016:Reference Values; D027724:Reproductive Techniques, Assisted; D012680:Sensitivity and Specificity; D053625:Sperm Retrieval; D013091:Spermatogenesis / Q000502:physiology*; D055815:Young Adult
D005640:Follicle Stimulating Hormone
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