Table 1 Overview of preoperative factors considered for prediction of micro-TESE outcome
From: Predictive factors of successful microdissection testicular sperm extraction
Predictive factors of micro-TESE | Comments |
|---|---|
Serum FSH | FSH, although a good predictor of global testicular function, does not serve by itself as a predictor of successful micro-TESE, but models have shown some predictive value when used in conjunction with other variables [14, 19–22] |
Serum Inhibin B | Inhibin B, like FSH, does not serve as a good predictor of micro-TESE by itself, but models have shown predictive value when used in conjunction with other variables [15, 19] |
Histopathology | Histopathology is likely the greatest single predictor of successful micro-TESE, but the requirement of a separate surgical procedure for diagnosis makes its role very limited [35, 59] |
Testicular volume | The data on testicular volume and its predictive value for micro-TESE is limited, and suggests that it is not a good predictive variable for micro-TESE [36, 37] |
Genetics | Genetics, particularly Y chromosome microdeletions, are very helpful in predicting success of micro-TESE; men with AZFc microdeletions have very good chance of successful micro-TESE, whereas those men with AZFa or AZFb have a low probability of success [6, 39] |
Klinefelter’s Syndrome (KS) | Men with KS have successful micro-TESE rates similar to or better than all men with NOA, and KS itself is a good prognostic factor for sperm retrieval [43, 45] |
Age | While advanced paternal age may play a role in decreased pregnancy rates, the limited studies thus far show that it does not play a predictive role for micro-TESE (unpublished data) |
Cryptorchidism | Men with a history of cryptorchidism have successful micro-TESE rates to men without cryptorchidism, suggesting that it does not play a predictive role in the success of micro-TESE [50] |
Varicocele | The need for varicocelectomy in men with a varicocele and NOA prior to micro-TESE is debated, but men with a clinical varicocele who undergo varicocelectomy prior to micro-TESE have higher sperm retrieval rates compared to men with all other causes of NOA, suggesting that varicocele repair is a positive prognostic factor for men undergoing micro-TESE [55, 57, 58] |