The predictive value of serum sex hormones for the outcome of testicular sperm aspiration in azoospermia

Azoospermia is a condition that affects the reproductive health of approximately 1% of the male population, typically diagnosed through testicular biopsy. Noninvasive serum markers can play a significant role in the diagnosis of azoospermia diagnosis. This study aims at evaluating the predictive value of serum sex hormone levels to improve the outcome of sperm extraction in azoospermia patients. The data from 203 patients with azoospermia from the Urology and Reproductive Andrology Department of Peking University, Shenzhen Hospital, between January 2017 and March 2022. The cases were divided into the sperm extraction group (95 cases) and the non-sperm extraction group (108 cases), based on pathology results. The levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), and inhibin B (INHB) were collected and their predictive effect on the outcome of sperm extraction by testicular sperm aspiration was discussed using statistical analysis. The levels of FSH and LH were lower in the sperm extraction group were lower compared to those in the non-sperm extraction group, while the levels of T and INHB were higher in the sperm extraction group than those in the non-sperm extraction group. These differences were statistically significant (p < 0.05). Receiver Operating Characteristic-Area Under the Curve (ROC-AUC) of INHB was 0.950, ROC-AUC of FSH was 0.893, ROC-AUC of LH was 0.78, and that of testosterone was 0.593. The best predictive point of INHB was 94.30 pg/mL, and that of FSH was 10.95 IU/L, calculated by the Youden index. The levels of four serum sex hormones were significantly different between the sperm extraction group and the non-sperm extraction group. The findings suggest that FSH and inhibin B are the ideal serum predictors of the outcome of sperm extraction by testicular sperm aspiration.

Testicular sperm aspiration; Follicle-stimulating hormone; Inhibin B

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