Successful repeat microdissection testicular sperm extraction in men with nonobstructive azoospermia.
OBJECTIVE
We studied factors that can predict successful repeat microdissection testicular sperm extraction in men with nonobstructive azoospermia.


METHODS
We retrospectively analyzed the records of 126 men with nonobstructive azoospermia who underwent 1 successful microdissection testicular sperm extraction attempt. Clinical factors identifiable at the second procedure, including age, testicular volume, endocrinological data and histology, were analyzed.


RESULTS
Overall testicular spermatozoa were successfully retrieved at 103 of 126 repeat attempts (82%). Men with a successful repeat attempt had lower follicle-stimulating hormone (mean±SD 23.1±12.4 vs 29.2±12.8, p=0.04) and larger testicular volume (mean 10±5 vs 7±4, p=0.0001) at the repeat procedure compared to men with a failed repeat attempt. Adjusted associations from a multiple logistic regression model showed that no factors predicted sperm retrieval during repeat microdissection testicular sperm extraction. An ROC curve showed a fair prediction model (AUC=0.71).


CONCLUSIONS
The follicle-stimulating hormone level and testicular volume at the repeat attempt appear to have predictive value to determine the success of a second attempt. These observations are interesting since testicular volume and follicle-stimulating hormone in men with nonobstructive azoospermia do not predict sperm retrieval at a primary microdissection testicular sperm extraction attempt.
Department of Urology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York 10065, USA.
Ranjith
R
Ramasamy
Joseph A
JA
Ricci
Robert A
RA
Leung
Peter N
PN
Schlegel
D000328:Adult; D053713:Azoospermia / Q000601:surgery; D006801:Humans; D008297:Male; D042282:Microdissection; D012189:Retrospective Studies; D053625:Sperm Retrieval