Clinical Predictors of Micro-Testicular Sperm Extraction Success in Nonobstructive Azoospermia With Complete...

To evaluate the clinical and histopathological parameters of sperm retrieval success using micro-testicular sperm extraction (micro-TESE) in nonobstructive azoospermia (NOA) with complete azoospermia factor c (AZFc) microdeletion, since there is limited data in the literature on the outcomes of this patient group and controversial results on the parameters affecting the success of micro-TESE in NOA patients.

The data of 1308 patients with NOA who underwent micro-TESE surgery at two centers between 2014 and 2022 were retrospectively analyzed. Clinical and histopathological data were comparatively assessed in men with complete AZFc microdeletion according to sperm retrieval success.

Among the 1308 men, 54 (4.1%) were diagnosed with complete AZFc microdeletion. Micro-TESE was successful in retrieving sperm from 28 men with AZFc microdeletion (51.8%). The patient age, follicle-stimulating hormone and total testosterone levels, duration of infertility, and testicular volume did not statistically significantly differ between the sperm-positive and -negative groups (P>.05). The analysis revealed that parental consanguinity was significantly different between the two groups (P=.032). According to the testicular biopsy results in terms of sperm retrieval status, no statistically significant difference was observed in the distribution of histopathological patterns.

Parental consanguinity was found to be the only parameter that negatively affected the success of micro-TESE in patients with NOA who presented with AZFc microdeletion. Clinical parameters, including patient age, follicle-stimulating hormone and total testosterone levels, and testis volume, did not demonstrate predictive value for sperm retrieval success in micro-TESE in this patient population.