NONOBSTRUCTIVE AZOOSPERMIA, FOLLICLE-STIMULATING HORMONE AS A MARKER OF SUCCESSFUL SPERM RETRIEVAL

Testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI) was revolutionized treatment of infertile men with azoospermia. Predictive factors for the presence of spermatozoa in testis are still under debate. Serum FSH levels reflect the state of seminiferous epitelium. Serum FSH has been evaluated as a predictor of success sperm retrieval rate (SRR) in NOA (37 cases 46XY men), but even among men with the highest FSH (30,0 - 40,0 mU/ml) spermatozoon was found. Men with FSH serum level 10 - 15 mU/ml had the SRR 0%. TESA is as a simple, minimally invasive approach for sperm retrieval. In our study sperm retrieval rate was 46%. In our practice we advised TESA as a first step and FSH can predict the success. TESA it is not only a diagnostic procedure to define the level of spermatogenesis, but also a therapeutic technique to retrieve sperm for ICSI. Also, in cases of negative results after TESE and hypospermatogenesis by histopatology we advised re-TESA after 3-6 months.