Ana Angélica Gratão

Predictive factors for motile sperm recovery using testicular biopsy in nonobstructive azoospermic patients

Objective: The objective of the presentstudy was to assess the predictive value ofhormone values, histological analysis for thefinding of motile spermatozoa on testicularbiopsy in nonobstructive azoospermia.Methods: This cross-sectional studyassessed serum follicle-stimulating hormone(FSH), luteinizing hormone, prolactin and totaltestosterone values in 50 patients undergoingtesticular biopsy prior to ICSI. P< 0.05 wasconsidered significant.Results: Recovery was successful in 28cases, and motile spermatozoa were retrieved in7. Significant differences were detectedbetween presence of motile spermatozoa andabsence of spermatozoa in terms of FSH values(P = 0.003, one-way ANOVA). The other variablesdid not present statistical differences. Areceiver operating characteristic curve showedthat FSH levels below 17.00 IU/L werepredictive of motile spermatozoa recovery.Conclusions: FSH values can serve as apredictive factor for the recovery of motilespermatozoa using biopsy in azoospermicpatients. On the other hand, histologicalanalysis and other hormone values were nothelpful in the prediction of motile sperm.

Hormônio folículo estimulante como preditor do achado de espermatozóides móveis na biópsia testicular de casos de azoospermia

OBJECTIVE To define predictive factors of mobile spermatozoa recovery in azoospermic patients. METHODS Testicular volume, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone levels were assessed in 60 azoospermic patients. Patients underwent bilateral testicular biopsy with local anesthesia. Samples were classified according to absence of spermatozoa, presence of motile and nonmotile spermatozoa, and histological findings. Age, hormone levels, testicular volume and histology with motile spermatozoa recovery were compared. P < 0.05 was considered significant. RESULTS Non-obstructive azoospermia was diagnosed in 45 patients. Significant differences were detected between the group with motile spermatozoa recovery and the group with absence of spermatozoa in terms of FSH levels (P=0.037 ANOVA one-way). A ROC curve was used to define FSH values below 16.05 IU/L (sensitivity: 76.2%, specificity: 67.7%) as predictive factors for motile spermatozoa recovery. Other statistical differences were not detected. CONCLUSIONS FSH levels below 16.05 IU/L showed good accuracy to predict the presence of motile spermatozoa in the testicular biopsy of azoospermic patients. Physical examination, testosterone levels, LH and prolactin were not useful as predictive factors in the present study.