Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia

Barlas, Irfan Safak; Tunc, Lutfi; bulut, ender cem; Doğan, Ahmet Emin; coşar, uğur

doi:10.5505/ejm.2021.05924

Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia

İrfan Şafak BARLAS, (Van Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Van, Türkiye)

Lütfi TUNÇ, (Gazi Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Ankara, Türkiye)

Ahmet Emin DOĞAN, (Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara, Türkiye)

Uğur COŞAR, (Diyarbakır Dağkapı Devlet Hastanesi, Üroloji Kliniği, Diyarbakır, Türkiye)

Ender Cem BULUT (Van Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Van, Türkiye)

Eastern Journal of Medicine

5 0

Yıl: 2021 Cilt: 26 Sayı: 2 Sayfa Aralığı: 286 - 293 Metin Dili: İngilizce DOI: 10.5505/ejm.2021.05924 İndeks Tarihi: 15-05-2021

Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia

Öz:

The aim of the study was to evaluate the relation between the probability of positive sperm extraction with Testicular Sperm Extraction (TESE) and the clinical, laboratory and demographic features in a series of non-obstructive azoospermia (NOA) infertility patients who consulted to Urology Department in order to determine and inform couples who could not succeed and thus avoid unnecessary treatment.Sixty-four patients with non-obstructive azoospermia were enrolled to the study. Demographical features and previous varicocele operation history were noted. In all cases serum levels of Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), genetic analysis and bilateral testicular volume were determined to find the correlation between probability of positive sperm extraction with TESE.The incidence of NOA among all infertile men was 15.1%. TESE success rate in NOA was 29,6%. There were significant differences in FSH levels (p<0,001), LH levels (p=0,006), right testicular volume (p<0,001), and left testicular volume (p<0,001). The results were evaluated by ROC analysis. Success rate of TESE was decreased when FSH>8,9mIU/ml (sensitivity 80%, specifity68%), LH>4,25mIU/ml (sensitivity 76%, specifity 53%), right testicular volume<8,5ml (sensitivity84%, specifity56%) and left testicular volume<7,25ml (sensitivity 84%, specifity56%) in NOA. As there was no paramater with one hundred percent sensitivity, probability of positive sperm retrieval would stil exist in these patients.In NOA cases increased FSH and LH levels, decreased testis volumes have negative effect at sperm retrieval. Chromosomal damages like Klinefelter Syndrome also decrease success rate. Determining groups with poor prognosis, may help prevention of patients from unnecessary processes, risks and costs.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Rowe PJ, Combraire FH, Hargreave TB, Mahmoud AMA. WHO Manuel for the Strandardized Investigation, Diagnosisand Management of infertile Male. Cambrige University Press. Cambrige: UK, 2000.
2. Thompson ST et al. Urol. Clin. North. Am 1994; 365: 21.
3. Mosher WD, Pratt WF. Fecundity and Infertility in the United States: Incidens and Trends Fertil Steril 1991; 56: 192-193.
4. McClure RD. Male infertility: Smith’s General Urology(14th ed). Tanagho EA, McAninch JW Simon and Schuster: Connecticut 1995; 739-771.
5. Sigman M, Howards SS. Male infertility: Campbell’s Urology(7th ed). Walsh PC, Retik AB, Vaughan ED, Wein AJ (Ed) WB Saunders: Philadelphia 1998; 1287-1330.
6. Sokol RZ et al. Endocrinology and male infertility: Infertility and Reproductive Medicine Clinics of North America Vol 10 Number 3. Whertman PE WB Saunders: Philadelpia 1999; 427-434.
7. Steptoe PC, Edwards R. Birth after the reimplantation of human embryo. Lacent 1978; 2: 366.
8. Palermo G, Joris H, Devroey P, Van steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an ooctye. Lancet 1992; 340: 17-18.
9. Birmingham, AL. Intracytoplasmic sperm injection (ICSI): American Society for Reproductive Medicine Practice Committee report. ASRM 1994.
10. Brinsden R. A Textbook of in vitro fertilization and assisted Reproduction. New York: USA 1999; 10965.
11. Dubin L, Amelar RD. Etiologic factors in 1294 consecutive cases of male infertility. Fertil Steril 1971; 22; 496-474.
12. Palermo GD, Schelegel PN, Hariprashad JJ et al. Fertilization and pregnancy out come with intracytplasmic sperm injection for azoospermic men. Humn Reprod 1999; 14: 741-748.
13. Turek PJ, Givens C, Schriock ED et al. Testes sperm extraction and intracytoplasmic sperm injection guided by prior fine needle aspiration mapping in nonobstructive azoospermia. Fertil Steril 1999; 71: 522-525.
14. Stanwell_Smith RE, Hendry WF. The prognosis of male subfertility: a survey of 1025 men referred to a fertility clinic. Br J Urol 1984; 56: 422-428.
15. Schlegel PN. Sperm retrieval techniques for assisted reproduction. In Werthman PE (eds): Infertility and Reproduction Medicine Clinics of North America. W.B Saunders company 1999; 10: 539-555.
16. Guler I, Erdem M, Erdem A, Demirdağ E, Tunc L, et al. Impact of testicular histopathology as a predictor of sperm retrieval and pregnancy outcome in patients with nonobstructive azoospermia: correlation with clinical and hormonal factores. Andrologia 2016; 48: 765-773.
17. Guneri C, Alkibay T, Tunc L. Effects of clinical, laboratuary and pathological features on successful sperm retrieval in non-obstructive azoospermia. Turk J Urol 2016; 42: 168-177.
18. Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S, Van Steirteghem AC, Devroey P. Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod 1997; 12: 80-86.
19. Ishikawa T, Fujioka H, Fujisawa M. Clinical and hormonal findings in testicular maturation arrest. BJU Int 2004; 94: 1314-1316.
20. De Kretser DM, Burger HG, Hudson B. The relationship between germinal cells and serum FSH levels in males with infertility. J Clin Endocrinol Metab 1974; 38: 787-793.
21. Schwarzer JU, Fiedler IV, Hertwig G. Et al. Male factors determining the outcome of intracytoplasmic sperm injection with epididymal and testicular spermatozoa. Andrologia 2003; 35: 220-226.
22. Vernaeve V, Tournaye H, Schiettecatte J, Verheyen G et al. Serum inhibin B can not predict testicular sperm retrieval in patients with non-obstructive azoospermia. Hum Reprod 2002; 17: 971-976.
23. Lipshultz LI, Corriere JN Jr. Progressive testicular atrophy in the varicocele patient. J Urol 1977; 117: 175-176.
24. Naughton CK et al. Pathophysiology of varicoceles in male infertility. Hum Reprod Update 2001; 7: 473-481.
25. Tunc L, Gurocak S, Sozen S, Tan O, Alkibay T, Bozkırlı I. Is varicocele a prognostic factor for determining sperm retrieval rate before testiculer sperm extraction? Arch Androl 2005; 51: 159-164.
26. Friedler S, Raziel A, Strassburger D, Schachter M, Bern O, Ron-El R. Outcome of ICSI using fresh and cryopreserved-thawed testicular spermatozoa in patients with non-mosaic Klinefelter’s Sydrome. Hum Reprod 2001; 16: 2616-2620.
27. Levron J, Aviram-Goldring A, Madgar I, Raviv G, Barkai G, Dor J. Sperm chromosome an alysis and outcome of IVF in patients with non-mosaic Klinefelter’s Syndrome. Fertil Steril 2000; 74: 925-929.
28. Vernaeve V, Staessen C, Verheyen G, Van Steirteghem A, Devroey P, Tournaye H. Can biological or clinical parameters predict testicular sperm recovery in 47,XXY Klinefelter’s Syndrome patients? Hum Reprod 2004; 19: 1135-1139.
29. Rejio R, Lee TY, Salo P, Alagappan R, Brown LG, Rosenberg M, et al. Diverse spermatogenic defects in humans caused by Y chromosome deletions encompassing a novel RNA-binding protein gene. Nat Genet 1995; 10: 383-393.
30. Martinez MC, Bernabe MJ, Gomez E, Ballesteros A, Landeras J, Glover G, Gil-Salom M, Remohi J andPellicer A. Screening for AZF deletion in a large series of severely impaired spermatogenesis patients. J. Androl 2000; 21: 651-655.
31. Ferlin A, Arredi B, Speltra E, Cazzadore C, Selice R, Garolla A, Lenzi A, Foresta C. Molecular and clinical characterization of Y chromosome microdeletions in infertile men: a 10-year experience in Italy. J Clin Endocrinol Metab 2007; 92: 762-770.
32. Choi JM, Chung P, Veeck L, Mielnik A, Palermo GD, Schlegel PN. AZF microdeletions of the Y chromosome and in vitro fertilization outcome. Fertil Steril 2004; 81: 337-341.

APA	Barlas I, Tunc L, Doğan A, coşar u, bulut e (2021). Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. , 286 - 293. 10.5505/ejm.2021.05924
Chicago	Barlas Irfan Safak,Tunc Lutfi,Doğan Ahmet Emin,coşar uğur,bulut ender cem Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. (2021): 286 - 293. 10.5505/ejm.2021.05924
MLA	Barlas Irfan Safak,Tunc Lutfi,Doğan Ahmet Emin,coşar uğur,bulut ender cem Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. , 2021, ss.286 - 293. 10.5505/ejm.2021.05924
AMA	Barlas I,Tunc L,Doğan A,coşar u,bulut e Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. . 2021; 286 - 293. 10.5505/ejm.2021.05924
Vancouver	Barlas I,Tunc L,Doğan A,coşar u,bulut e Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. . 2021; 286 - 293. 10.5505/ejm.2021.05924
IEEE	Barlas I,Tunc L,Doğan A,coşar u,bulut e "Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia." , ss.286 - 293, 2021. 10.5505/ejm.2021.05924
ISNAD	Barlas, Irfan Safak vd. "Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia". (2021), 286-293. https://doi.org/10.5505/ejm.2021.05924

APA	Barlas I, Tunc L, Doğan A, coşar u, bulut e (2021). Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. Eastern Journal of Medicine, 26(2), 286 - 293. 10.5505/ejm.2021.05924
Chicago	Barlas Irfan Safak,Tunc Lutfi,Doğan Ahmet Emin,coşar uğur,bulut ender cem Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. Eastern Journal of Medicine 26, no.2 (2021): 286 - 293. 10.5505/ejm.2021.05924
MLA	Barlas Irfan Safak,Tunc Lutfi,Doğan Ahmet Emin,coşar uğur,bulut ender cem Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. Eastern Journal of Medicine, vol.26, no.2, 2021, ss.286 - 293. 10.5505/ejm.2021.05924
AMA	Barlas I,Tunc L,Doğan A,coşar u,bulut e Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. Eastern Journal of Medicine. 2021; 26(2): 286 - 293. 10.5505/ejm.2021.05924
Vancouver	Barlas I,Tunc L,Doğan A,coşar u,bulut e Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia. Eastern Journal of Medicine. 2021; 26(2): 286 - 293. 10.5505/ejm.2021.05924
IEEE	Barlas I,Tunc L,Doğan A,coşar u,bulut e "Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia." Eastern Journal of Medicine, 26, ss.286 - 293, 2021. 10.5505/ejm.2021.05924
ISNAD	Barlas, Irfan Safak vd. "Effects of Testicular Volume, Follicle Stimulating Hormone, Luteinizing Hormone and Presence of Varicocele On Successful Sperm Retrieval In Non-Obstructive Azoospermia". Eastern Journal of Medicine 26/2 (2021), 286-293. https://doi.org/10.5505/ejm.2021.05924