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Predictive model to estimate the chances of successful sperm retrieval by testicular sperm aspiration in patients with nonobstructive azoospermia

Fertility and Sterility Oct 15, 2020

Majzoub A, Arafa M, Khalafalla K, et al. - Via performing retrospective chart review of a total of 297 patients with nonobstructive azoospermia, researchers here examined predictors of successful sperm retrieval (SR) and sought to determine potentially suitable candidates for testicular sperm aspiration (TESA), a more straightforward, less traumatic, and less costly procedure than open surgical SR methods. Clinical evaluation of all patients was performed prior to performing a staged SR procedure, starting with TESA and proceeding to microsurgical testicular sperm extraction (microTESE). Overall, 23.6% of patients undergoing TESA had a positive SR. LASSO regression analysis suggested average testis size and serum follicle-stimulating hormone (FSH) level as the significant predictors of positive SR. A TESA-positive SR of 43% was reported for patients presenting with an average testis size > 7.75 mL and serum FSH level < 8.5 IU/L. Per these observations, TESA appears to be a suitable alternative to microTESE in selected nonobstructive azoospermia patients presenting with an average testis size > 7.75 mL and serum FSH level < 8.5 IU/L.

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