Probability to retrieve testicular spermatozoa in azoospermic patients

Aim: The degree of probability to retrieve spermatozoa from testicular tiss ue for intracytoplasmic sperm injection into oocytes is of interest for cou nselling of infertility patients. We investigated the relation of sperm ret rieval to clinical data and histological pattern in testicular biopsies fro m azoospermic patients. Methods: In 264 testicular biopsies from 142 azoosp ermic patients, the testicular tissue was shredded to separate the spermato zoa, histological semi - thin sections of which were then evaluated using J ohnsen score. Results: The retrieval of spermatozoa correlated significantl y (P < 0.001) with the testicular volume (r = 0.49), the FSH concentration (r = -0.66), the maximum score (r = 0.85) and the mean Johnsen score (r = 0 .81). In the multivariate regression analysis the successful testicular spe rm extraction showed the closest relationship to the maximum score. The tes ticular volume correlated significantly with the mean Johnsen score (r = 0. 64, P < 0.001), and the basal serum FSH concentration mainly with the maxim um score (r = - 0.77; P < 0.001). Patients with a history cryptorchidism sh owed a significantly lower Johnsen score compared to the patients who did n ot have any testicular disease in the past (3.7 +/- 2.4 vs. 5.9 +/- 2.5; P < 0.01). Conclusion: In a limited range, the testicular volume and the FSH concentration in serum were related to the Johnsen score which correlated s ignificantly with the sperm retrieval. The successful sperm retrieval can b e expected in all azoospermic patients irrespective of the results of clini cal examination. However, the probability of retrieval of spermatozoa decre ased significantly in patients with a FSH level > 18 U/L, testicular volume < 5 mL, mean Johnsen score < 5, and maximum Johnsen score < 7.