Parameters affecting sperm retrieval rates of microscopic testicular sperm extraction in non-obstructive azoospermic patients

Parameters affecting sperm retrieval rates of microscopic testicular sperm extraction in non-obstructive azoospermic patients This study aimed to evaluate parameters that may have an effect on sperm retrieval rates with microscopic testicular sperm extraction (micro-TESE) in patients with infertility and diagnosed to have non-obstructive azoospermia (NOA). Data of 860 NOA patients who underwent micro-TESE procedures between years 2003 and 2014 at Başkent University Adana Practice and Research Center were reviewed, retrospectively. The impact of age, duration of infertility, history of varicocelectomy, history of orchiopexy, history of herniorraphy, presence of solitary testis, smoking, result of previous testicular biopsy, history of orchitis, human chorionic gonadotropin use history in the last 3 months, presence of undescended or retractile testis, presence of varicocele, testicular volume, serum levels of follicle stimulating and luteinizing hormones and testosterone, presence of Klinefelter's syndrome and presence of Y chromosome microdeletion on sperm retrieval rates with micro-TESE was investigated. The overall sperm retrieval rate with micro-TESE in NOA patients was 45.8%. Multivaryant anlysis showed that presence of spermatozoa in a previous testicular biopsy (OR= 15.3; p< 0.001), presence of previous varicocelectomy (OR= 1.5; p= 0.041) and higher testicular volumes (OR= 1.08; p= 0.02) were positive predictive parameters for sperm retrieval. Cutoff value for testicular volume was estimated as 11 mL (AUC= 0.641; p< 0.001). To our knowledge this study evaluated the impact of largest number of parameters on sperm retrieval rates with micro-TESE in the largest series of NOA patients. The results appear conclusive in predicting the probabality of sperm retrieval in in NOA patients scheduled for micro-TESE procedure. Key words: Non-obstructive azoospermia, micro-TESE, testicular sperm extraction, sperm retrieval rate