(255) Operating Characteristics of Sperm Concentration and FSH for Predicting Chromosomal Abnormalities

Abstract Introduction Microdeletions of the Y-chromosome (Yq) and karyotype abnormalities are frequent causes male factor infertility. Current AUA/EUA guidelines recommend obtaining Yq microdeletion analysis, karyotype, genetic counseling in men with non-obstructive azoospermia or severe oligospermia (<5 mil/mL). A recent retrospective cohort study suggests that microdeletions primarily found at a sperm concentration < 0.5 mil/mL by lowering threshold for testing, specificity could be increased relative financial cost decreased without adversely affecting sensitivity. Studies have shown FSH is best predictor NOA combination testicular volume as well significant presence. Identification implications when patients (and their partners) about likelihood retrieving need further counseling. Objective We hypothesized would better predict presence chromosome infertile men. Methods was conducted subjects who were referred to military tertiary Urology clinic between 2010 2020 underwent an infertility evaluation include testing (karyotype, analysis), hormone profile (FSH), least one semen analysis. Sperm density analyzed independent predictors chromosomal using logistic regression. Receiver operating characteristics generated each variable achieved significance Results total 356 met inclusion criteria. Over ten-year period, prevalence 3.3% (n=12) 8.4% (n=30), respectively. The ability abnormality based on regression statistically variable. area under curve than alone (0.71 vs 0.66, p=0.033). balance sensitivity (i.e. diagnostic test) cut-points 8.345 mIU/mL, To optimize performance screening test maintain >90%, cut points 2.74 There no difference 2-7 if exceeded 7 mil/mL; thus cutoff capture 100% all abnormalities. Conclusions Based receiver characteristics, analysis <1 maintains acceptable abnormality, resulting savings expected. Incorporating into this decision appears improve both prediction Our single-institution cohort, exemplifies potential improvement patient selection results can lowered from current Disclosure No