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Predictive factors for successful testicular biopsy
Duarte Vieira Brito1, Manuel Lopes2, Jose Pereira3
1Urology and Renal Transplantation Department, Coimbra University Hospital Centre. duartevbrito@hotmail.com.
Summary
Predicting the success of testicular biopsies for infertility can be challenging. However, normal testicular volume, testosterone, and FSH levels, along with type 1 diabetes mellitus, increase the likelihood of a positive biopsy outcome in azoospermic men.
Area of Science:
- Reproductive Medicine
- Andrology
- Urology
Background:
- Infertility affects 10-15% of US couples, often requiring complex evaluation of males.
- Testicular biopsy is frequently necessary for diagnosing male infertility, particularly in cases of azoospermia.
Purpose of the Study:
- To identify predictors of positive testicular biopsy outcomes in azoospermic men undergoing infertility investigation.
- To correlate hormonal profiles and clinical factors with the presence of viable sperm in testicular biopsies.
Main Methods:
- Retrospective review of 117 azoospermic men undergoing testicular biopsy between January 2015 and December 2021.
- Comparison of patients with positive (sperm presence) versus negative biopsy results.
- Analysis of serum hormone levels (testosterone, FSH, LH) and clinical factors.
Main Results:
- A positive testicular biopsy (presence of sperm) was observed in 48.7% of patients.
- Patients with positive biopsies had significantly higher serum total testosterone (3.7 vs. 2.85 ng/mL) and lower FSH levels (6.0 vs. 16.0 mIU/mL) compared to those with negative biopsies.
- Serum LH levels did not significantly differ between the groups.
Conclusions:
- Predicting testicular biopsy success remains difficult.
- Normal testicular volume, normal testosterone and FSH levels, and type 1 diabetes mellitus are associated with a higher probability of a positive testicular biopsy.
- These findings may aid in counseling and managing infertile men with azoospermia.
