You have accessJournal of UrologyInfertility: Basic Research & Pathophysiology1 Apr 2018MP60-18 ANTI-MULLERIAN HORMONE-TO-TESTOSTERONE RATIO IS PREDICTIVE OF POSITIVE SPERM RETRIEVAL IN MEN WITH IDIOPATHIC NON-OBSTRUCTIVE AZOOSPERMIA Massimo Alfano, Eugenio Ventimiglia, Irene Locatelli, Paolo Capogrosso, Walter Cazzaniga, Filippo Pederzoli, Nicola Frego, Rayan Matloob, Antonino Saccà, Luca Boeri, Luca Pagliardini, Paola Viganò, Marina Pontillo, Manuela Nebuloni, Francesco Montorsi, and Andrea Salonia Massimo AlfanoMassimo Alfano More articles by this author , Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Irene LocatelliIrene Locatelli More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Filippo PederzoliFilippo Pederzoli More articles by this author , Nicola FregoNicola Frego More articles by this author , Rayan MatloobRayan Matloob More articles by this author , Antonino SaccàAntonino Saccà More articles by this author , Luca BoeriLuca Boeri More articles by this author , Luca PagliardiniLuca Pagliardini More articles by this author , Paola ViganòPaola Viganò More articles by this author , Marina PontilloMarina Pontillo More articles by this author , Manuela NebuloniManuela Nebuloni More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1910AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The lack of clinically-reliable biomarkers makes impossible to predict sperm retrieval outcomes at testicular sperm extraction (TESE) in men with non-obstructive azoospermia (NOA) undergoing in vitro fertilization programs, resulting in up to 50% of unnecessary surgical interventions. Aim of the study was to identify novel and user-friendly prognostic factors reliably predicting surgical outcomes in iNOA men in the real-life setting. METHODS Clinical data, hormonal profile and histological classification of testis parenchyma from 47 white-Caucasian idiopathic NOA (iNOA) men submitted to microdissection TESE (microTESE) were analyzed. Logistic regression analyses tested potential clinical predictors of positive sperm retrieval. The predictive accuracy of all variables was evaluated using the receiver operating characteristic-derived area under the curve, and the clinical net benefit estimated by a decision-curve analysis (DCA). RESULTS Overall, 23 (49%) and 24 (51%) patients were classified as positive and negative sperm retrievals at microTESE. While circulating hormones associated to a condition of primary hypogonadism did not predict sperm retrieval, levels of anti-Mullerian hormone (AMH) and the ratio AMH-to-total Testosterone (AMH/tT) achieved independent predictor status for sperm retrieval at microTESE, with a predictive accuracy of 93% and 95%, respectively. Using cutoff values of <4.62 ng/ml for AMH and <1.02 for AMH/tT, positive sperm retrieval was predicted in all individuals, with 19 men out of 47 potentially spared from surgery. DCA findings demonstrated clinical net benefit using AMH and AMH/tT for patient selection at microTESE. CONCLUSIONS Major achievement of this study is the novel identification of circulating AMH levels and AMH/tT values as two potential user-friendly biomarkers with high predictive accuracy toward positive sperm retrieval at microTESE, with > 93% accuracy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e796-e797 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Massimo Alfano More articles by this author Eugenio Ventimiglia More articles by this author Irene Locatelli More articles by this author Paolo Capogrosso More articles by this author Walter Cazzaniga More articles by this author Filippo Pederzoli More articles by this author Nicola Frego More articles by this author Rayan Matloob More articles by this author Antonino Saccà More articles by this author Luca Boeri More articles by this author Luca Pagliardini More articles by this author Paola Viganò More articles by this author Marina Pontillo More articles by this author Manuela Nebuloni More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...