Predictive value of FSH, testicular volume, and histopathological findings for the sperm retrieval rate of microdissection TESE in nonobstructive azoospermia: a meta-analysis / 亚洲男科学杂志(英文版)

We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (TESE) in patients with nonobstructive azoospermia (NOA). All relevant studies were searched in PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO. We chose three parameters to perform the meta-analysis: follicle-stimulating hormone (FSH), testicular volume, and testicular histopathological findings which included three patterns: hypospermatogenesis (HS), maturation arrest (MA), and Sertoli-cell-only syndrome (SCOS). If there was a threshold effect, only the area under the summary receiver operating characteristic curve (AUSROC) was calculated. Otherwise, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and the diagnostic odds ratio (DOR) were also calculated. Twenty-one articles were included in our study finally. There was a threshold effect among studies investigating FSH and SCOS. The AUSROCs of FSH, testicular volume, HS, MA, and SCOS were 0.6119, 0.6389, 0.6758, 0.5535, and 0.2763, respectively. The DORs of testicular volume, HS, and MA were 1.98, 16.49, and 1.26, respectively. The sensitivities of them were 0.80, 0.30, and 0.27, while the specificities of them were 0.35, 0.98, and 0.76, respectively. The PLRs of them were 1.49, 10.63, and 1.15, respectively. And NLRs were 0.73, 0.72, and 0.95, respectively. All the investigated factors in our study had limited predictive value. However, the histopathological findings were helpful to some extent. Most patients with HS could get sperm by microdissection TESE.

Testicular biopsies--histomorphologic patterns in male infertility.

The objective of the present study is to observe the spectrum of histopathological changes in the testicular biopsies of infertile men and to assess if a bilateral biopsy is required to reveal the pathology of infertility in every case or a unilateral biopsy would suffice. Thirty testicular biopsies (21 bilateral and 9 unilateral) were studied from 30 infertile men. The patterns of testicular damage seen in the present study were maturation arrest followed by hypospermatogenesis, Sertoli-cell only syndrome, tubular hyalinisation and one case was associated with normal histology. Comparing the histopathological findings in bilateral biopsies, it was seen that a unilateral biopsy would suffice to reveal the pathology in most instances and a bilateral biopsy is needed only when there is appreciable difference in the size of the testes.