Nonobstructive azoospermia, when we can find spermatozoa, is FSH as a marker of succes?

Abstract

Azoospermia is the absence of spermatozoa in ejaculate even after semen centrifugation at least two times. Azoospermia due to spermatogenic failure – non-obstructive azoospermia (NOA) observed in 1% of population and in 10–15% of infertile men. Predictive factors for the presence of spermatozoa in testis are still under debate. The development of ICSI revolutionized management of azoospermia. In our practice we advised TESA as a first step and FSH can predict the success.  According serum FSH levels we divided our men in three groups: FSH < 10 mU/ml, 10–15 mU/ml and  > 15 mU/ml. We tried to evaluated SRR in accordance serum FSH level and find significant difference. In 117 men with FSH < 10 mU/ml SRR was 66% (in 77 cases), in 89 men which FSH was 10–15 mU/ml SRR was 27 % and finally SRR was 35% when FSH was > 15 mU/ml (45 cases from 131). At the same time, we make embryologist personal assessment (EPA) and try to show embryologist crucial role in tissue assessment after TESA. Another crucial point of discussion – histomorphology within the testis in NOA and indications for             re – TESA after 3–6 months.