Fausto Negri, Edoardo Pozzi, Christian Corsini, Massimiliano Raffo, Federico Belladelli, Alessandro Bertini, Francesco Cattafi, Eugenio Ventimiglia, Rayan Matloob, Antonino Saccà, Luca Boeri, Alessia d'Arma, Francesco Montorsi, Andrea Salonia
{"title":"非阻塞性无精子症男性显微解剖睾丸精子提取后的短期激素变化：来自一项大型纵向前瞻性多中心研究的结果。","authors":"Fausto Negri, Edoardo Pozzi, Christian Corsini, Massimiliano Raffo, Federico Belladelli, Alessandro Bertini, Francesco Cattafi, Eugenio Ventimiglia, Rayan Matloob, Antonino Saccà, Luca Boeri, Alessia d'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.5534/wjmh.240184","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate possible hormonal changes following microdissection testicular sperm extraction (mTESE) in men with non-obstructive azoospermia (NOA) across three referral centers.</p><p><strong>Materials and methods: </strong>We prospectively analyzed data from 102 consecutive NOA men. Patients with prior hormonal therapies were excluded. Preoperative serum hormone levels (total testosterone [tT], luteinizing hormone [LH], follicle-stimulating hormone [FSH], and 17β-estradiol) were collected, with repeat measurements at 3-month post-surgery. We divided the cohort into two groups using a tT cut-off value of 3 ng/mL: 1) men who kept eugonadal status; and, 2) men who were initially eugonadal but became testosterone deficient (TD) after surgery.</p><p><strong>Results: </strong>Overall, median (interquartile range [IQR]) age was 37 years (32-40 years). Positive sperm retrieval during mTESE was observed in 34 (33.3%) patients, and 48 (47.1%) underwent bilateral mTESE. Compared to baseline, 3-month postoperative median (IQR) hormonal levels were as follows: tT: 3.71 ng/mL (2.76-5.24 ng/mL) <i>vs.</i> 4.27 ng/mL (3.25-6.07 ng/mL), p=0.32; FSH: 22.0 mIU/mL (12.65-31.47 mIU/mL) <i>vs.</i> 19.5 mIU/mL (11.63-25.8 mIU/mL), p=0.25; LH: 9.0 mIU/mL (5.11-12.4 mIU/mL) <i>vs.</i> 7.6 mIU/mL (5.04-13.4 mIU/mL), p=0.73, respectively. Twelve (13.5%) eugonadal men at baseline showed TD after mTESE. Median (IQR) tT values at baseline and 3-month follow-up were compared between those who preserved eugonadal status after surgery and those who became TD after surgery: baseline levels were 4.46 ng/mL (4.1-6.27 ng/mL) <i>vs.</i> 4.14 ng/mL (3.24-4.98 ng/mL), p=0.09; and, 3-month follow-up levels were 4.58 ng/mL (3.58-5.56 ng/mL) <i>vs.</i> 2.51 ng/mL (2.31-2.76 ng/mL), p<0.001, respectively. Men who developed TD had lower testicular volume (TV) (6 [4-10] vs. 10 [8-12.25] Prader, p=0.001) and karyotype abnormalities (4 [33.3] <i>vs.</i> 1 [1.3], p=0.006).</p><p><strong>Conclusions: </strong>This multicentric study shows that mTESE in men with NOA does not significantly impact short-time postoperative follow-up tT, LH, and FSH levels. A substantial proportion of men who were initially eugonadal demonstrated tT suggestive for TD at 3-month follow-up. These men had lower TV at baseline and abnormal karyotype.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Short-Term Hormonal Changes Following Microdissection Testicular Sperm Extraction among Men with Non-Obstructive Azoospermia: Findings from a Large Longitudinal Prospective Multicentric Study.\",\"authors\":\"Fausto Negri, Edoardo Pozzi, Christian Corsini, Massimiliano Raffo, Federico Belladelli, Alessandro Bertini, Francesco Cattafi, Eugenio Ventimiglia, Rayan Matloob, Antonino Saccà, Luca Boeri, Alessia d'Arma, Francesco Montorsi, Andrea Salonia\",\"doi\":\"10.5534/wjmh.240184\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>We aimed to investigate possible hormonal changes following microdissection testicular sperm extraction (mTESE) in men with non-obstructive azoospermia (NOA) across three referral centers.</p><p><strong>Materials and methods: </strong>We prospectively analyzed data from 102 consecutive NOA men. Patients with prior hormonal therapies were excluded. Preoperative serum hormone levels (total testosterone [tT], luteinizing hormone [LH], follicle-stimulating hormone [FSH], and 17β-estradiol) were collected, with repeat measurements at 3-month post-surgery. We divided the cohort into two groups using a tT cut-off value of 3 ng/mL: 1) men who kept eugonadal status; and, 2) men who were initially eugonadal but became testosterone deficient (TD) after surgery.</p><p><strong>Results: </strong>Overall, median (interquartile range [IQR]) age was 37 years (32-40 years). Positive sperm retrieval during mTESE was observed in 34 (33.3%) patients, and 48 (47.1%) underwent bilateral mTESE. Compared to baseline, 3-month postoperative median (IQR) hormonal levels were as follows: tT: 3.71 ng/mL (2.76-5.24 ng/mL) <i>vs.</i> 4.27 ng/mL (3.25-6.07 ng/mL), p=0.32; FSH: 22.0 mIU/mL (12.65-31.47 mIU/mL) <i>vs.</i> 19.5 mIU/mL (11.63-25.8 mIU/mL), p=0.25; LH: 9.0 mIU/mL (5.11-12.4 mIU/mL) <i>vs.</i> 7.6 mIU/mL (5.04-13.4 mIU/mL), p=0.73, respectively. Twelve (13.5%) eugonadal men at baseline showed TD after mTESE. Median (IQR) tT values at baseline and 3-month follow-up were compared between those who preserved eugonadal status after surgery and those who became TD after surgery: baseline levels were 4.46 ng/mL (4.1-6.27 ng/mL) <i>vs.</i> 4.14 ng/mL (3.24-4.98 ng/mL), p=0.09; and, 3-month follow-up levels were 4.58 ng/mL (3.58-5.56 ng/mL) <i>vs.</i> 2.51 ng/mL (2.31-2.76 ng/mL), p<0.001, respectively. Men who developed TD had lower testicular volume (TV) (6 [4-10] vs. 10 [8-12.25] Prader, p=0.001) and karyotype abnormalities (4 [33.3] <i>vs.</i> 1 [1.3], p=0.006).</p><p><strong>Conclusions: </strong>This multicentric study shows that mTESE in men with NOA does not significantly impact short-time postoperative follow-up tT, LH, and FSH levels. A substantial proportion of men who were initially eugonadal demonstrated tT suggestive for TD at 3-month follow-up. These men had lower TV at baseline and abnormal karyotype.</p>\",\"PeriodicalId\":54261,\"journal\":{\"name\":\"World Journal of Mens Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2024-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Mens Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5534/wjmh.240184\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANDROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Mens Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5534/wjmh.240184","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANDROLOGY","Score":null,"Total":0}
Short-Term Hormonal Changes Following Microdissection Testicular Sperm Extraction among Men with Non-Obstructive Azoospermia: Findings from a Large Longitudinal Prospective Multicentric Study.
Purpose: We aimed to investigate possible hormonal changes following microdissection testicular sperm extraction (mTESE) in men with non-obstructive azoospermia (NOA) across three referral centers.
Materials and methods: We prospectively analyzed data from 102 consecutive NOA men. Patients with prior hormonal therapies were excluded. Preoperative serum hormone levels (total testosterone [tT], luteinizing hormone [LH], follicle-stimulating hormone [FSH], and 17β-estradiol) were collected, with repeat measurements at 3-month post-surgery. We divided the cohort into two groups using a tT cut-off value of 3 ng/mL: 1) men who kept eugonadal status; and, 2) men who were initially eugonadal but became testosterone deficient (TD) after surgery.
Results: Overall, median (interquartile range [IQR]) age was 37 years (32-40 years). Positive sperm retrieval during mTESE was observed in 34 (33.3%) patients, and 48 (47.1%) underwent bilateral mTESE. Compared to baseline, 3-month postoperative median (IQR) hormonal levels were as follows: tT: 3.71 ng/mL (2.76-5.24 ng/mL) vs. 4.27 ng/mL (3.25-6.07 ng/mL), p=0.32; FSH: 22.0 mIU/mL (12.65-31.47 mIU/mL) vs. 19.5 mIU/mL (11.63-25.8 mIU/mL), p=0.25; LH: 9.0 mIU/mL (5.11-12.4 mIU/mL) vs. 7.6 mIU/mL (5.04-13.4 mIU/mL), p=0.73, respectively. Twelve (13.5%) eugonadal men at baseline showed TD after mTESE. Median (IQR) tT values at baseline and 3-month follow-up were compared between those who preserved eugonadal status after surgery and those who became TD after surgery: baseline levels were 4.46 ng/mL (4.1-6.27 ng/mL) vs. 4.14 ng/mL (3.24-4.98 ng/mL), p=0.09; and, 3-month follow-up levels were 4.58 ng/mL (3.58-5.56 ng/mL) vs. 2.51 ng/mL (2.31-2.76 ng/mL), p<0.001, respectively. Men who developed TD had lower testicular volume (TV) (6 [4-10] vs. 10 [8-12.25] Prader, p=0.001) and karyotype abnormalities (4 [33.3] vs. 1 [1.3], p=0.006).
Conclusions: This multicentric study shows that mTESE in men with NOA does not significantly impact short-time postoperative follow-up tT, LH, and FSH levels. A substantial proportion of men who were initially eugonadal demonstrated tT suggestive for TD at 3-month follow-up. These men had lower TV at baseline and abnormal karyotype.
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