Journal Article
Randomized Controlled Trial
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[Impacts of different procedures of testicular sperm retrieval on testicular function and antisperm antibodies in azoospermia patients].

Objective: To investigate the influence of different procedures of testicular sperm retrieval on the levels of serum inhibin B (INHB), antisperm antibodies (AsAb), follicle-stimulating hormone (FSH), and testosterone (T) in patients with azoospermia.

METHODS: We randomly assigned 210 azoospermia patients to receive testicular sperm extraction (TESE, n = 50), testicular sperm aspiration (TESA, n = 56), testicular fine needle aspiration (TEFNA, n = 64), or microscopic TESE (micro-TESE, n = 40). We measured the levels of serum INHB, FSH, and T and the positive rate of AsAb before and at 1 and 3 months after surgery.

RESULTS: Compared with the baseline, the levels of serum FSH at 1 and 3 months after surgery showed no statistically significant differences in the TESE ([8.51 ± 4.34] vs [8.76 ± 3.07] and [7.24 ± 3.32] IU/L, P >0.05), TESA ([7.70 ± 2.72] vs [7.90 ± 4.57] and [8.04 ± 3.65] IU/L, P >0.05), TEFNA ([6.04 ± 3.17] vs [6.08 ± 2.70] and [6.10 ± 3.32] IU/L, P >0.05), or micro-TESE group ([6.59 ± 2.74] vs [6.89 ± 1.78] and [6.75 ± 2.57] IU/L, P >0.05); the positive rate of AsAb (IgM) was significantly increased at 1 month in the TESE (0.00 vs 14.00%, P <0.05) and micro-TESE groups (2.50% vs 15.00%, P <0.05), while the serum T level markedly decreased in the two groups ([16.52 ± 6.25] vs [9.25 ± 5.76] nmol/L and [14.16 ± 5.45] vs [8.23 ± 4.12] nmol/L, P <0.05); the levels of serum INHB were remarkably reduced at 1 and 3 months in the TESE ([70.56 ± 23.17] vs [42.63 ± 15.34] and [44.05 ± 18.47] pg/ml, P <0.05), TESA ([68.71 ± 14.74] vs [40.55 ± 20.51] and [42.11 ± 19.34] pg/ml, P <0.05), TEFNA ([76.81 ± 27.04] vs [46.31 ± 19.28] and [48.32 ± 20.54] pg/ml, P <0.05), and micro-TESE groups ([74.74 ± 28.35] vs [45.27 ± 18.83] and [47.64 ± 28.34] pg/ml, P <0.05), but with no statistically significant differences among the four groups (P >0.05).

CONCLUSIONS: Different procedures of testicular sperm retrieval have different impacts on the testicular function and AsAb in patients with azoospermia.

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