Predictive factors of successful testicular sperm extraction for non-obstructive azoospermia with a history of bilateral cryptorchidism and normal testosterone.

Abstract

This study aimed to assess the predictive factors of successful sperm retrieval in non-obstructive azoospermia with a history of bilateral cryptorchidism. This retrospective study included 103 patients with azoospermia who had micro-dissection testicular sperm extraction between January 2010 and January 2020. The median (range) age of the patients and their wives in the study group was 33 (21-44) and 24 (19-33)years, respectively. The patients with low testosterone level (<3ng/dl) were prescribed with human chorionic gonadotropin 5,000IU injection every 3days for 3months. Those with persistent low testosterone even after hormonal stimulation were excluded. Sperms were retrieved from 64 (62%) patients, whilst failed in 39 (38%) patients. On univariate analysis, the median testicular volume was significantly larger in the successful group versus the failed group (p<.001), serum FSH and serum LH were significantly lower in the successful group (p=.001), serum testosterone was significantly higher in the successful group compared to the failed group (p<.001) and the age of orchidopexy was lower in the successful group versus the failed group (p=.016). On multivariate analysis, the average testicular volume and the serum testosterone levels were independent factors for successful sperm retrieval.