Clinical Parameters as Predictors for Sperm Retrieval Method and Success in Non-Obstructive Azoospermia (NOA): Experience from Indonesia
SIU Academy®. Indra Rachman R. 11/12/21; 342125; UP-08.13 Topic: Treatment
Dr. Rinaldo Indra Rachman
Dr. Rinaldo Indra Rachman
Contributions
Abstract
Clinical Parameters as Predictors for Sperm Retrieval Method and Success in Non-Obstructive Azoospermia (NOA): Experience from Indonesia

Topic: Infertility

Applicant 1: Rinaldo Indra, Applicant 2: Ghifari, Applicant 3: Widi, Applicant 4: Nur, Applicant 5: Ponco

Applicant 1: Rachman, Applicant 2: Nurullah, Applicant 3: Atmoko, Applicant 4: Rasyid, Applicant 5: Birowo

Applicant 1: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 2: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 3: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 4: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 5: Universitas Indonesia, Cipto Mangunkusumo Hospital

Applicant 1: Indonesia, Applicant 2: Indonesia, Applicant 3: Indonesia, Applicant 4: Indonesia, Applicant 5: Indonesia

Applicant 1: Presenting Author, Applicant 2: Author/Co-Author, Applicant 3: Author/Co-Author, Applicant 4: Author/Co-Author, Applicant 5: Author/Co-Author

Introduction and Objectives:

This study aims to find useful clinical parameters useful to predict sperm retrieval methods and success. In this way, it assists andro-urologists in predicting sperm retrieval technique and success based on individual patient\'s clinical parameters. As a result, it improves preparation efficiency and reduces costs for patients.

Materials and Methods:

A retrospective cohort study was performed on 323 NOA patients between January 2010 to May 2021 who underwent sperm retrieval procedure by author in Jakarta, Indonesia. Clinical evaluation, scrotal ultrasound to evaluate varicocele presence, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone level were evaluated before surgery. Thereafter, clinically indicated patients underwent percutaneous epididymal sperm aspiration (PESA) followed by testicular sperm extraction (TESE) only if sperm was not found during PESA. The primary outcome is sperm retrieval success and the secondary outcome is the sperm retrieval method.

Results:

In total, there were 323 NOA patients included. The mean patient age was 37.1 years and the sperm retrieval success was 38.7%. Bivariate analysis shows a significant difference in serum FSH and LH level in sperm retrieval success. Serum FSH and LH levels for the successful sperm retrieval group were higher than the unsuccessful group. In addition, both FSH and LH levels were higher in patients who underwent TESE rather than PESA. Further multivariate analysis showed that FSH (Adjusted RR 0.941, 95% CI 0.900-0.984; p= 0.008) is the only independent factor for sperm retrieval method selection. There was no significant difference in age, infertility type, presence of varicocele to predict sperm retrieval method and success in NOA (see Table 1).

Conclusion:

In conclusion, a higher level of FSH and LH is useful to predict sperm retrieval success. Moreover, serum FSH level is an independent factor for TESE rather than PESA performed.

Clinical Parameters as Predictors for Sperm Retrieval Method and Success in Non-Obstructive Azoospermia (NOA): Experience from Indonesia

Topic: Infertility

Applicant 1: Rinaldo Indra, Applicant 2: Ghifari, Applicant 3: Widi, Applicant 4: Nur, Applicant 5: Ponco

Applicant 1: Rachman, Applicant 2: Nurullah, Applicant 3: Atmoko, Applicant 4: Rasyid, Applicant 5: Birowo

Applicant 1: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 2: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 3: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 4: Universitas Indonesia, Cipto Mangunkusumo Hospital, Applicant 5: Universitas Indonesia, Cipto Mangunkusumo Hospital

Applicant 1: Indonesia, Applicant 2: Indonesia, Applicant 3: Indonesia, Applicant 4: Indonesia, Applicant 5: Indonesia

Applicant 1: Presenting Author, Applicant 2: Author/Co-Author, Applicant 3: Author/Co-Author, Applicant 4: Author/Co-Author, Applicant 5: Author/Co-Author

Introduction and Objectives:

This study aims to find useful clinical parameters useful to predict sperm retrieval methods and success. In this way, it assists andro-urologists in predicting sperm retrieval technique and success based on individual patient\'s clinical parameters. As a result, it improves preparation efficiency and reduces costs for patients.

Materials and Methods:

A retrospective cohort study was performed on 323 NOA patients between January 2010 to May 2021 who underwent sperm retrieval procedure by author in Jakarta, Indonesia. Clinical evaluation, scrotal ultrasound to evaluate varicocele presence, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone level were evaluated before surgery. Thereafter, clinically indicated patients underwent percutaneous epididymal sperm aspiration (PESA) followed by testicular sperm extraction (TESE) only if sperm was not found during PESA. The primary outcome is sperm retrieval success and the secondary outcome is the sperm retrieval method.

Results:

In total, there were 323 NOA patients included. The mean patient age was 37.1 years and the sperm retrieval success was 38.7%. Bivariate analysis shows a significant difference in serum FSH and LH level in sperm retrieval success. Serum FSH and LH levels for the successful sperm retrieval group were higher than the unsuccessful group. In addition, both FSH and LH levels were higher in patients who underwent TESE rather than PESA. Further multivariate analysis showed that FSH (Adjusted RR 0.941, 95% CI 0.900-0.984; p= 0.008) is the only independent factor for sperm retrieval method selection. There was no significant difference in age, infertility type, presence of varicocele to predict sperm retrieval method and success in NOA (see Table 1).

Conclusion:

In conclusion, a higher level of FSH and LH is useful to predict sperm retrieval success. Moreover, serum FSH level is an independent factor for TESE rather than PESA performed.

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