Investigating discordance between embryologists and histopathologists: analysis of multiple factors in mTESE sperm retrieval outcomes.

Abstract

The objective of the study is to primarily highlight the consistency between the embryologist and the histopathologist in microdissection testicular sperm extraction and to explore the factors affecting sperm retrieval. The research included 91 patients, aged 20 to 47, who visited our Reproductive Technology center from July 2020 to June 2023. Patient data were collected retrospectively, including demographics, physical exams, lab tests, radiological assessments, genetic analyses, medical histories and histopathological results. Using the Johnsen scoring system for evaluation, the histopathologist identified mature spermatozoa in the specimen in some patients (Johnsen score 8-10); however, the embryologist only declared successful sperm retrieval in 66.6% of them. Overall sperm retrieval rates were lower than expected at 40%. Significant factors influencing sperm retrieval rates included Follicle Stimulating Hormone (p = 0.001), Luteinizing Hormone (p = 0.007), testicular volume (p < 0.001), histopathology (p < 0.001), and alcohol consumption (p = 0.007). A logistic regression model was used to identify the independent predictors of successful sperm retrieval. FSH (p = 0.038), testicular volume (p < 0.001), histopathology (p < 0.001), and alcohol consumption (p = 0.013) emerged as significant predictive factors for the outcome of sperm retrieval. As a result, in addition to patient-related factors, the consistency between the pathologist and embryologist also affects sperm retrieval rates.