Population Council Research that makes a difference

Abstract

High serum FSH levels in men with nonobstructive azoospermia does not affect success of microdissection testicular sperm extraction (HTML) 
Ramasamy,Ranjith; Lin,Kathleen; Veeck Gosden,Lucinda; Rosenwaks,Zev R.; Palermo,Gianpiero D.; Schlegel,Peter N.
Fertility and Sterility 92(2): 590-593
Publication date: 2009

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Objective
To evaluate the outcomes of microdissection testicular sperm extraction (micro-TESE) in patients with high FSH.

Design
Clinical retrospective study.

Setting
Department of urology at a tertiary university hospital.

Patient(s)
Seven hundred ninety-two men with nonobstructive azoospermia.

Intervention(s)
Micro-TESE followed by intracytoplasmic sperm injection was performed. The men were classified into four groups based on serum FSH levels: <15, 15-30, 31-45, and >45 IU/mL.

Main Outcome Measure(s)
Sperm retrieval, clinical pregnancy, and live birth rates.

Result(s)
Testicular sperm were successfully retrieved in 60% of the men. Sperm retrieval rates in the groups of men with FSH values 15-30, 31-45, and >45 IU/mL was 60%, 67%, and 60% respectively; this was higher than the group of men with FSH < 15 (51%). Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the four groups (46%, 50%, 52%, 46% and 38%, 45%, 44%, 36%, respectively).

Conclusion(s)
The chances of sperm retrieval using micro-TESE is just as common, if not better for men with elevated FSH levels than for men with lower FSH. Micro-TESE results appear to differ from earlier series that report low retrieval rates with random biopsies for men with elevated FSH. High FSH is not a contraindication for micro-TESE.

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