Factors determining the sperm retrieval rate in fresh versus salvage micro-TESE: a comparative cohort study

• Published in: International urology and nephrology 2019-03, Vol.51 (3), p.401-408
• Main Authors: Amer, Medhat Kamel, Ahmed, Ahmed Ragab, Hamid, Asmaa Ahmed Abdel, GamalEl Din, Sameh Fayek
• Format: Article
• Language: English
• Subjects: Age; Cohort analysis; Follicle-stimulating hormone; Histopathology; Infertility; Medicine; Medicine & Public Health; Nephrology; Sperm; Testes; Urology; Urology - Original Paper
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-019-02086-5

Purpose We studied prospectively the role of FSH, testis volume, age, duration of infertility, hormonal therapy, varicocelectomy and testicular histopathology in determining the sperm retrieval rate (SRR) in fresh versus salvage micro-TESE. Methods Our study analysed retrospectively the prospectively maintained database of 330 NOA patients who underwent micro-TESE either 1st or 2nd or 3rd timers from January 2017 to August 2018 from the Andrology Clinic of a specialized IVF centre. They were divided equally into 3 groups, group (1) were 1st timers, group (2) were 2nd timers and group (3) were 3rd timers, respectively. Results Interestingly, our study demonstrated a positive correlation between high FSH level and favourable micro-TESE outcome in 1st timers who underwent micro-TESE (p 0.015). Additionally, our study revealed a positive correlation between age and favourable micro-TESE outcome in 2nd timers who underwent micro-TESE (p 0.031). Further, our study revealed a positive correlation between right testicular volume and favourable micro-TESE outcome in 1st timers who underwent micro-TESE (p 0.023). Eventually, there was a significant positive correlation between histopathology which was mainly sertoli cell only syndrome and favourable micro-TESE outcome in 1st timers micro-TESE (p 0.001). Conclusion Our study demonstrates that sperms can be retrieved despite high FSH level, and preoperative histopathology is not essential in predicting SRR in NOA patients. Further, age can be considered a good prognostic factor in patients who undergo salvage micro-TESE for the 2nd time.