title: Operating characteristics of follicle-stimulating hormone in azoospermic men.
abstract: OBJECTIVE
  To validate factors predictive of nonobstructive azoospermia (NOA) and to determine the operating characteristics of FSH for predicting NOA.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary care military treatment facility.
  
  
  METHODS
  One hundred forty azoospermic males undergoing infertility evaluation.
  
  
  METHODS
  Standard evaluation included history and physical, hormonal workup, and genetic evaluation. Diagnostic testicular biopsy was offered to characterize patients as obstructive azoospermia (OA) or NOA.
  
  
  METHODS
  Semen volume, semen fructose, FSH, T, E₂, PRL, testicular atrophy.
  
  
  RESULTS
  Seventy-eight of 140 azoospermic patients underwent a biopsy. The ability to predict NOA based on logistic regression was statistically significant for FSH and testicular atrophy. On multivariate analysis, only FSH remained predictive of NOA. The area under the FSH receiver operating characteristic curve was 0.847, which is significant. The cut point of FSH with the highest likelihood ratio of predicting NOA on biopsy was ≥12.3 mIU/mL.
  
  
  CONCLUSIONS
  FSH remains the best predictor of NOA. With full knowledge of the operating characteristics of FSH in this population, a patient can be properly educated and treatment can be individualized, based on the specific risk associated with that subject's measured FSH.
authors.affiliation: Department of Urology, Naval Medical Center San Diego, San Diego, California. Electronic address: matthew.christman@med.navy.mil.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Christman
authors.affiliation: Department of Urology, Naval Medical Center San Diego, San Diego, California.
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Gudeman
authors.affiliation: Department of Urology, Naval Medical Center San Diego, San Diego, California.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Nork
authors.affiliation: Department of Urology, Naval Medical Center Portsmouth, Portsmouth, Virginia.
authors.forename: R Chanc
authors.initials: RC
authors.lastname: Walters
authors.affiliation: Department of Urology, Naval Medical Center San Diego, San Diego, California.
authors.forename: James O
authors.initials: JO
authors.lastname: L'Esperance
authors.affiliation: Department of Urology, Naval Medical Center San Diego, San Diego, California.
authors.forename: Donald S
authors.initials: DS
authors.lastname: Crain
mesh_terms: D000328:Adult; D001284:Atrophy; D053713:Azoospermia / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D005640:Follicle Stimulating Hormone / Q000378:metabolism* / Q000592:standards; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012661:Semen / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005640:Follicle Stimulating Hormone
keywords: Follicle stimulating hormone; azoospermia; infertility; operating characteristics