MP21-04 SUCCESSFUL SPERM RETRIEVAL FOR MEN WITH Y CHROMOSOME AZFC MICRODELETION

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP21)1 Sep 2021MP21-04 SUCCESSFUL SPERM RETRIEVAL FOR MEN WITH Y CHROMOSOME AZFC MICRODELETION I-Shen Huang, Wei-Jen Chen, and William J Huang I-Shen HuangI-Shen Huang More articles by this author , Wei-Jen ChenWei-Jen Chen More articles by this author , and William J HuangWilliam J Huang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002006.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Among the genetic aberrations contributing to male infertility, the deletion of the AZFc region of the Y chromosome is a common cause of spermatogenetic failure and the chances for successful surgical sperm extraction from azoospermic men with AZFc region microdeletion are relatively good. Nevertheless, it is still a challenge to procure sperm from a sizeable proportion of individuals with AZFc microdeletion, even when meticulous surgical measures are employed. The objective of this study is to identify predictive factors for successful sperm retrieval in men with AZFc microdeletion. METHODS: 76 infertile men were studied, each having Y chromosome AZFc microdeletion at some time during a 10-year period, as confirmed by multiplex polymerase chain reaction (PCR) amplification of STS (sequence tagged site). For each patient, the endocrine profile including serum follicle stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), prolactin (PRL) and estradiol (E2) was recorded, along with intratesticular testosterone level (ITT), age and testicular size. The factors were further analyzed to determine the key predictors for successful sperm retrieval. RESULTS: Of the 76 men with AZFc microdeletion, 56 were classified as having non-obstructive azoospermia (NOA), 8 as having cryptozoospermia, and 12 as having severe oligoasthenoteratozoospermia (OAT). Of the 56 men with azoospermia, 50 received microdissection TESE (mTESE), and sperm retrieval was successful in 37 of those cases (74 %). A significantly lower serum FSH (P = 0.02) was found in those patients from whom sperm could be successfully retrieved. On the other hand, parameters such as levels of LH, TT, PRL, E2, testicular volume and age were not found to be correlated with successful sperm recovery. The area under the receiving operating characteristic (ROC) curve (AUC) for FSH was determined to be 0.721. Using an FSH cut-off point of 12.95 mIU/mL according to Youden’s index, the model for predicting successful sperm retrieval was found to have 51.4% sensitivity, 84.6% specificity, 90.5% positive predictive value (PPV) and 37.9% negative predictive value (NPV). CONCLUSIONS: Men exhibiting AZFc microdeletion with discernible spermatogenesis from whom sperm was successfully retrieved by mTESE generally presented with relatively lower FSH levels. Source of Funding: nil © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e347-e347 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information I-Shen Huang More articles by this author Wei-Jen Chen More articles by this author William J Huang More articles by this author Expand All Advertisement Loading ...