The prognostic value of the testicular histopathological pattern for sperm retrieval and intracytoplasmic sperm injection outcomes in non-obstructive azoospermic patients

Abstract

Objective: To evaluate the prognostic value of testicular histology on sperm retrieval success and intracytoplasmic sperm injection (ICSI) outcomes. Methods: Sixty couples undergoing testicular spermaspiration (TESA) for ICSI were divided into threegroups according to their testicular histopathologicaldiagnosis: (i) Hypospermatogenesis (HS, N=24), (ii)Maturation arrest (MA, N=17), and (iii) Sertoli-cell-onlysyndrome (SCOS, N=19). Sperm retrieval success andICSI outcomes were compared. The relationship betweenhistological diagnosis and (i) serum FSH value and (ii)testicular volume was also investigated.Results: Sperm retrieval rate (HS: 91.6%, MA: 35.2%and SCOS: 26.3%, p<0.001) and fertilization rate (HS:69.9%, MA: 49.3%, and SCOS: 43.3%, p=0.048) weresignificantly higher in HS group. A trend towards ahigher percentage of high-quality embryos was noted inHS group (HS: 55.0%, MA: 31.0% and SCOS: 30.9%,p=0.076). No differences in testicular volume wereobserved. Nevertheless, FSH value was significantly higherin SCOS patients (HS: 10.2±5.4 mIU/mL, MA: 9.9±6.8mIU/mL, and SCOS: 26.1±15.3 mIU/mL, p< 0.01).Conclusions: Histological findings present in testicularbiopsy specimens of NOA patients were able to predictsperm retrieval success and ICSI outcomes. An elevatedserum FSH level is significantly correlated with SCOSpresence in azoospermic patients. © Todos os direitos reservados a SBRA - Sociedade Brasileira de Reprodução Assistida.