Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia
<b>Background/Objectives</b>: Non-obstructive azoospermia (NOA) is a severe form of male infertility characterized by the absence of sperm in the ejaculate due to impaired spermatogenesis. Testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection is the primary tr...
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MDPI AG
2024-11-01
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| author | Aris Kaltsas Sofoklis Stavros Zisis Kratiras Athanasios Zikopoulos Nikolaos Machairiotis Anastasios Potiris Fotios Dimitriadis Nikolaos Sofikitis Michael Chrisofos Athanasios Zachariou |
| author_facet | Aris Kaltsas Sofoklis Stavros Zisis Kratiras Athanasios Zikopoulos Nikolaos Machairiotis Anastasios Potiris Fotios Dimitriadis Nikolaos Sofikitis Michael Chrisofos Athanasios Zachariou |
| author_sort | Aris Kaltsas |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Non-obstructive azoospermia (NOA) is a severe form of male infertility characterized by the absence of sperm in the ejaculate due to impaired spermatogenesis. Testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection is the primary treatment, but success rates are unpredictable, causing significant emotional and financial burdens. Traditional clinical and hormonal predictors have shown inconsistent reliability. This review aims to evaluate current and emerging non-invasive preoperative predictors of successful sperm retrieval in men with NOA, highlighting promising biomarkers and their potential clinical applications. <b>Methods</b>: A comprehensive literature review was conducted, examining studies on clinical and hormonal factors, imaging techniques, molecular biology biomarkers, and genetic testing related to TESE outcomes in NOA patients. The potential role of artificial intelligence and machine learning in enhancing predictive models was also explored. <b>Results</b>: Traditional predictors such as patient age, body mass index, infertility duration, testicular volume, and serum hormone levels (follicle-stimulating hormone, luteinizing hormone, inhibin B) have limited predictive value for TESE success. Emerging non-invasive biomarkers—including anti-Müllerian hormone levels, inhibin B to anti-Müllerian hormone ratio, specific microRNAs, long non-coding RNAs, circular RNAs, and germ-cell-specific proteins like TEX101—show promise in predicting successful sperm retrieval. Advanced imaging techniques like high-frequency ultrasound and functional magnetic resonance imaging offer potential but require further validation. Integrating molecular biomarkers with artificial intelligence and machine learning algorithms may enhance predictive accuracy. <b>Conclusions</b>: Predicting TESE outcomes in men with NOA remains challenging using conventional clinical and hormonal parameters. Emerging non-invasive biomarkers offer significant potential to improve predictive models but require validation through large-scale studies. Incorporating artificial intelligence and machine learning could further refine predictive accuracy, aiding clinical decision-making and improving patient counseling and treatment strategies in NOA. |
| format | Article |
| id | doaj-art-fb9696e1aece44e290ef0aeaa975fb2c |
| institution | DOAJ |
| issn | 2227-9059 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Biomedicines |
| spelling | doaj-art-fb9696e1aece44e290ef0aeaa975fb2c2025-08-20T02:55:54ZengMDPI AGBiomedicines2227-90592024-11-011212267910.3390/biomedicines12122679Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive AzoospermiaAris Kaltsas0Sofoklis Stavros1Zisis Kratiras2Athanasios Zikopoulos3Nikolaos Machairiotis4Anastasios Potiris5Fotios Dimitriadis6Nikolaos Sofikitis7Michael Chrisofos8Athanasios Zachariou9Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceDepartment of Obstetrics and Gynecology, Royal Cornwall Hospital, Truro TR1 3LJ, UKThird Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceThird Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceDepartment of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceLaboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, GreeceThird Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, GreeceLaboratory of Spermatology, Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece<b>Background/Objectives</b>: Non-obstructive azoospermia (NOA) is a severe form of male infertility characterized by the absence of sperm in the ejaculate due to impaired spermatogenesis. Testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection is the primary treatment, but success rates are unpredictable, causing significant emotional and financial burdens. Traditional clinical and hormonal predictors have shown inconsistent reliability. This review aims to evaluate current and emerging non-invasive preoperative predictors of successful sperm retrieval in men with NOA, highlighting promising biomarkers and their potential clinical applications. <b>Methods</b>: A comprehensive literature review was conducted, examining studies on clinical and hormonal factors, imaging techniques, molecular biology biomarkers, and genetic testing related to TESE outcomes in NOA patients. The potential role of artificial intelligence and machine learning in enhancing predictive models was also explored. <b>Results</b>: Traditional predictors such as patient age, body mass index, infertility duration, testicular volume, and serum hormone levels (follicle-stimulating hormone, luteinizing hormone, inhibin B) have limited predictive value for TESE success. Emerging non-invasive biomarkers—including anti-Müllerian hormone levels, inhibin B to anti-Müllerian hormone ratio, specific microRNAs, long non-coding RNAs, circular RNAs, and germ-cell-specific proteins like TEX101—show promise in predicting successful sperm retrieval. Advanced imaging techniques like high-frequency ultrasound and functional magnetic resonance imaging offer potential but require further validation. Integrating molecular biomarkers with artificial intelligence and machine learning algorithms may enhance predictive accuracy. <b>Conclusions</b>: Predicting TESE outcomes in men with NOA remains challenging using conventional clinical and hormonal parameters. Emerging non-invasive biomarkers offer significant potential to improve predictive models but require validation through large-scale studies. Incorporating artificial intelligence and machine learning could further refine predictive accuracy, aiding clinical decision-making and improving patient counseling and treatment strategies in NOA.https://www.mdpi.com/2227-9059/12/12/2679non-obstructive azoospermiatesticular sperm extractionsperm retrieval predictorsmale infertilitybiomarkersanti-Müllerian hormone |
| spellingShingle | Aris Kaltsas Sofoklis Stavros Zisis Kratiras Athanasios Zikopoulos Nikolaos Machairiotis Anastasios Potiris Fotios Dimitriadis Nikolaos Sofikitis Michael Chrisofos Athanasios Zachariou Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia Biomedicines non-obstructive azoospermia testicular sperm extraction sperm retrieval predictors male infertility biomarkers anti-Müllerian hormone |
| title | Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia |
| title_full | Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia |
| title_fullStr | Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia |
| title_full_unstemmed | Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia |
| title_short | Predictors of Successful Testicular Sperm Extraction: A New Era for Men with Non-Obstructive Azoospermia |
| title_sort | predictors of successful testicular sperm extraction a new era for men with non obstructive azoospermia |
| topic | non-obstructive azoospermia testicular sperm extraction sperm retrieval predictors male infertility biomarkers anti-Müllerian hormone |
| url | https://www.mdpi.com/2227-9059/12/12/2679 |
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