No clear-cut markers for predicting positive sperm retrieval (+SR) at microdissection testicular sperm extraction (mTESE) have been identified thus far. Our aim was to conduct a systematic review and meta-analysis to evaluate the ability of follicle-stimulating hormone (FSH), inhibin B (InhB), and anti-Müllerian hormone (AMH) to predict +SR in men with nonobstructive azoospermia (NOA) undergoing mTESE.
We performed a search in the PubMed, EMBASE, Web of Science, and Scopus databases according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Thirty-four publications were selected for inclusion in the analysis.
Overall, the mean +SR rate was 45%. Pooled standardized mean difference (SMD) values revealed significant hormonal differences between the +SR and -SR groups, with lower FSH (SMD -0.30), higher InhB (SMD 0.54), and lower AMH (SMD -0.56) levels in the +SR group. Pooled odds ratios (Ors) revealed no significant prediction of +SR by either FSH (OR 1.03, 95% confidence interval [CI] 1.00-1.06) or InhB (OR 1.01, 95% CI 1.00-1.02), despite variations in baseline levels and study heterogeneity. Conversely, AMH had significant predictive value (OR 0.82, 95% CI 0.73-0.92), with lower baseline levels in the +SR group. InhB and FSH levels were higher in the +SR group, while InhB exhibited the opposite trend.
Despite study heterogeneity, our meta-analysis findings support the ability of AMH to predict +SR for men with NOA undergoing mTESE.
We conducted a review and analysis of results from previous studies. Our findings show that for men with an infertility condition called nonobstructive azoospermia, blood levels of anti-Müllerian hormone can predict successful extraction of sperm using a microsurgical technique. Levels of two other hormones did not predict successful sperm extraction.
European urology open science. 2024 May 27*** epublish ***
Edoardo Pozzi, Christian Corsini, Federico Belladelli, Alessandro Bertini, Fausto Negri, Massimiliano Raffo, Antonino Saccà, Eugenio Ventimiglia, Luca Boeri, Giuseppe Fallara, Alessia d'Arma, Luca Pagliardini, Paola Viganò, Marina Pontillo, Roberta Lucianò, Maurizio Colecchia, Ranjith Ramasamy, Francesco Montorsi, Massimo Alfano, Andrea Salonia
Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA., Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, AO Papa Giovanni XXIII, Bergamo, Italy., Department of Urology, Foundation IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy., Department of Urology, European Institute of Oncology, Milan, Italy., Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy., Reproductive Sciences Laboratory, Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Infertility Unit, Foundation IRCCS Ca' Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy., Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy., Unit of Pathology, IRCCS Ospedale San Raffaele, Milan, Italy.