P-3: Complete Reproductive Hormonal Study in Nonobstructive Azoospermic (NOA) Patients for Determining Reliable Markers of The Presence of Spermatozoa in Their Biopsies

Background: Various hormone tests of the presence of spermatozoa on testicular sperm extraction (TESE) in azoospermic men have been investigated. Because of its clinical importance, we conducted this study to evaluate complete reproductive serum hormone levels in nonobstructive azoospermic (NOA) patients for determining markers which can predict the spermatogenesis. Materials and Methods: Seventy one NOA infertile men who were referred to the Infertility and Andrology Clinic from February 2012 till March 2013 were participated in this Cross-sectional study. Blood samples were obtained and serum level of Inhibin B (Inh-B),Anti-Mullerian hormone(AMH), luteinizing hormone(LH), follicle-stimulating hormone(FSH), testosterone and estradiol were measured (double-checked). The TESE was performed under general anesthesia and tissue samples were sent for sperm retrieval. Results: In 39 patients (55%) spermatozoa was detected in their biopsies (successful TESE) and in 32 patients (45%) it was not found (failed TESE). Serum LH level was significantly less in patients with successful TESE compared to the failed TESE group.(5.17 ± 2.62 mIU/ml vs. 9.28 ± 7.74 mIU/ml; p value: 0.007). Also,serum levels of AMH and FSH were significantly less in successful TESE group considering α=0.1 and confidence interval = 90%.(5.45 ± 3.45 ng/ml vs. 9.57 ± 8.89 ng/ml;P value;0.073 for AMH and 10.90 ± 14.55 mIU/ml vs. 17.56 ± 17.54 mIU/ml; p value:0.085 for FSH). Other serum hormone levels were not significantly different between the two groups. Conclusion: Triple serum hormone testing including LH, FSH and AMH can be recommended as a predictive hormonal study of the presence of testicular spermatozoa in nonobstructive azoospermic patients, although more studies with larger sample sizes are needed to confirm our results