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Updated: Jun 28, 2026
Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
High serum FSH levels in men with nonobstructive azoospermia does not affect success of microdissection testicular
Ranjith Ramasamy1, Kathleen Lin, Lucinda Veeck Gosden
1Center for Reproductive Medicine and Infertility, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, New York, USA.
Objective:
To evaluate the outcomes of microdissection testicular sperm extraction (micro-TESE) in patients with high FSH.
Design:
Clinical retrospective study.
Setting:
Department of urology at a tertiary university hospital.
Patient(S):
Seven hundred ninety-two men with nonobstructive azoospermia.
Intervention(S):
Micro-TESE followed by intracytoplasmic sperm injection was performed. The men were classified into four groups based on serum FSH levels: <15, 15-30, 31-45, and >45 IU/mL.
Main Outcome Measure(S):
Sperm retrieval, clinical pregnancy, and live birth rates.
Result(S):
Testicular sperm were successfully retrieved in 60% of the men. Sperm retrieval rates in the groups of men with FSH values 15-30, 31-45, and >45 IU/mL was 60%, 67%, and 60% respectively; this was higher than the group of men with FSH < 15 (51%). Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the four groups (46%, 50%, 52%, 46% and 38%, 45%, 44%, 36%, respectively).
Conclusion(S):
The chances of sperm retrieval using micro-TESE is just as common, if not better for men with elevated FSH levels than for men with lower FSH. Micro-TESE results appear to differ from earlier series that report low retrieval rates with random biopsies for men with elevated FSH. High FSH is not a contraindication for micro-TESE.
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