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Changes in Testosterone Levels Following Surgical Sperm Retrieval in Men with Non-Obstructive Azoospermia: Systematic
Wael Zohdy1,2, Rupin Shah2,3, Christopher Chee Kong Ho2,4
1Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.
The World Journal of Men'S Health
|September 30, 2024
Summary
Surgical sperm retrieval (SSR) significantly reduces total testosterone (TT) in azoospermic men. Post-procedure sexual dysfunction is linked to hypogonadism, especially after failed SSR or in Klinefelter syndrome.
Area of Science:
- Reproductive Medicine
- Andrology
- Endocrinology
Background:
- Surgical sperm retrieval (SSR) is crucial for treating infertility in men with azoospermia.
- SSR procedures may risk testicular damage, leading to hormonal imbalances and reduced testosterone levels.
Purpose of the Study:
- To evaluate the impact of SSR on serum total testosterone (TT), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testicular volume, and sexual function in infertile men with azoospermia.
Main Methods:
- A systematic review and meta-analysis (SRMA) was conducted, searching PubMed and Scopus for relevant studies.
- Seventeen studies involving 1,685 infertile azoospermic men were analyzed.
Main Results:
- A significant reduction in TT was observed post-SSR (MD 3.81 nmol/L, p=0.02).
- No significant changes were found in FSH, LH, or testicular volume.
- Sexual dysfunction correlated with hypogonadism, depression, and anxiety, particularly in cases of unsuccessful SSR or Klinefelter syndrome.
Conclusions:
- SSR leads to a significant decrease in total testosterone levels.
- Preoperative counseling should address the risks of sexual dysfunction and the potential impact of repeat SSR procedures.
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