Follicle-stimulating hormone and age as predictors forpositive sperm retrieval in patients with azoospermia

Abstract

Azoospermia is the complete absence of sperm in the semen, one of the causes of infertility, affecting around 1% of the male population and 10-12% of the male with infertility. Follicle-stimulating Hor-mone [FSH] and age are commonly used predictors to estimate the outcome of sperm retrieval. How-ever, the precision of the FSH level and age of patients as predictors for positive sperm retrieval is variable between studies. The purpose of this research was to investigate the effect of the patient’s age and FSH level on successful sperm retrieval. A pilot retrospective medical records review study was conducted. Sixty-eight infertile patients with azoospermia who underwent sperm retrieval pro-cedures were included. Trans-epididymal sperm aspiration [TESA] was conducted on 35 azoosper-mic patients, and 33 patients underwent trans-epididymal sperm extraction [TESE] at Albayda Fer-tility Teaching Centre/Libya. Data was collected from the 1st of October 2017 to the 15th of October 2022. SPSS software version 26 was used for data analysis. All the included subjects were with pri-mary subfertility. The total number of cases with successful sperm extraction were 34 [50%] and it was 17 [48.6%] and 17 [51.5%] for TESA and TESE respectively and the difference was non-signif-icant between the two procedures [χ2 = 0.059, p = 0.81]. Patients with successful sperm retrieval rates had significantly lower mean FSH levels [9.82 mIU/mL, SD ± 7.43] than patients with high FSH levels [16.26 mIU/mL, SD ± 11.56, p = 0.008]. The mean age of successful sperm retrieval was 41 years [SD ± 7 years]. Patients who were aged 40 years and above also had the highest extraction rate [71.0%] compared with patients between 20-29 years and 30-39 years [27.3% and 34.6%, re-spectively], and. Low FSH levels and older age were associated with a higher success rate of sperm retrieval. Further studies are warranted to investigate the cause of low sperm retrieval rates among younger azoospermic patients.