Histological and immunohistochemical outcomes after microdissection TESE in contrast with hormonal profile, testis volume and genetics in patients with azoospermia
Authors: Arian Iurii ,   Department of Urology and Surgical Nephrology, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova,   Laboratory of Andrology, Functional Urology and Sexual Medicine, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova,   * Corresponding Author: Iurii Arian, Department of Urology and Surgical Nephrology, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova. E-mail: arian_iurie@yahoo.com, Dumbraveanu Ion ,   Department of Urology and Surgical Nephrology, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova,   Laboratory of Andrology, Functional Urology and Sexual Medicine, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova, Ghenciu Victoria ,   Laboratory of Andrology, Functional Urology and Sexual Medicine, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova, Machidon Daniela ,   Laboratory of Andrology, Functional Urology and Sexual Medicine, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova, Ernu Ion ,   Laboratory of Andrology, Functional Urology and Sexual Medicine, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova, Ceban Emil ,   Department of Urology and Surgical Nephrology, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova,   Laboratory of Andrology, Functional Urology and Sexual Medicine, Nicolae Testemiţanu State University of Medicine and Pharmacy, Chisinau, Moldova
Published: May 2023

A limited number of individuals with non-obstructive azoospermia (NOA) may recover spermatozoa through traditional testicular sperm extraction (TESE) techniques. There is an ongoing debate over the effectiveness of microdissection TESE compared to standard TESE methods. Microdissection TESE (micro-TESE) techniques enable the identification of spermatogenesis foci in non-obstructive forms of azoospermia. Only histological examination can provide an objective and definitive assessment of the testicular phenotype. This study aimed to evaluate the correlation between histopathological findings after microdissection TESE (micro-TESE) and the predictive role of various factors in determining the success of sperm retrieval. We evaluated 24 patients with azoospermia who underwent micro-TESE and considered the patient's hormonal profile, testis ultrasound, genetic evaluation, histology, and immunohistology (PLAP antibody) of collected testis biopsies. The preoperative blood FSH level, in conjunction with other parameters, may aid in the prediction of micro-TESE success. Sensitivity increases, and specificity decreases with higher FSH levels. Furthermore, testicular volume and FSH levels are typically normal in patients with maturation arrest. In conclusion, hormones, ultrasound evaluation of the testicles, testis volume, and available genetic tests have a predictive value in differentiating obstructive azoospermia (OA) from NOA with various sensitivity and specificity rates. Histological and immunohistochemical evaluation establishes the testicular phenotype accurately and guides patient management.