Table 2.
Hormonal treatment and successful sperm retrieval (SSR) in patients with NOA undergoing micro-TESE.
| Study | Patients Characteristics | Treatment | Results |
|---|---|---|---|
| [55] | 108 men. 16 with SCO. 36 with focal SCO. 19 with MA. 37 with HYPO. All had serum FSH level below 8 mIU/mL | 63 men received FSH 75 IU 3 times/week. 45 received no treatment | SSR 64% (40/63) in FSH treated and 33% (15/45) in controls (p < 0.01) SCO 2/7 (28% controls) vs. 4/9 (44% treated) p = NS FSCO 4/16 (25%) vs. 13/20 (65% treated) (p < 0.01) MA 3/8 (37%) vs. 5/11 (45% treated) p = NS HYPO 6/14 (42%) vs. 18/23 (78% treated) p < 0.05 |
| [56] | 42 men with MA (42.9%) and HYPO (57.1%) | CC 25–75 mg/day to achieve T 600–800 ng/dL (study target) | 27/42 (64.3%) had sperm in the ejaculate; SSR 100% (15/15) |
| [34] | 348 out of 736 patients had subnormal T. 307 out of 348 received hormonal therapy. 41 (12%) received no treatment |
348 (47%) with low T (<300) and 388 with normal T (>300). 307 out of 348 (88%) were treated with hormonal therapy. 41 (12%) were not treated. |
SSR in 52% of patients with low T and in 56% of patients with normal T. SSR 51% in treated vs. 61% in untreated |
| [23] | 48 men with failed micro-TESE | 28 hCG/hCG plus FSH if FSH levels decreased during treatment. 20 received no treatment. T did not differ among groups |
Sperm retrieval 21% (treatment) vs. 0 (no treatment). |
| [57] | 608 men | 496 received CC, then hCG, and, eventually, hMG according to their response to CC, while 112 received no treatment. Target T level = 600–800 ng/dL | 10.9% of patients had sperm in the ejaculate; SSR was 57% in treated and 33% in controls |
| [51] | 20 men with failed micro-TESE | hCG followed by FSH if serum FSH < 2 | SSR 3/20 (15%). T did not differ among patients with SSR and SRF Spermatogonial PCNA expression increased in patients receiving FSH Patients with SSR had significantly lower basal ITT compared to those with SRF. Post-treatment ITT increased in all patients |
| [53] | 22 men with failed micro-TESE | All received hCG 5000 3 times a week; 12 patients received also FSH 150 thrice/week since FSH level dropped below 2 | SSR 4/22 (18%). A significant increase in the AR index was observed in 12 patients receiving FSH + hCG. AR index was significantly higher in men with SSR compared to SRF. T levels did not correlate with AR index |
| [58] | 1395 patients evaluated by different surgeons | SSR 450/1395 (32.2%) Hormonal therapy (CC or hCG or HMG or FSH or T or AI combination of drugs) in 426 patients |
SSR was 27.6% (118/426) in treated vs. 31.7% (308/969) in untreated. No data about T levels in treated vs. untreated. |
| [59] | 40 men with failed micro-TESE. | 20 received testosterone for 1 month. then FSH plus testosterone, while 20 received no treatment | SSR in salvage micro-TESE was 10% in treated vs. 0 in controls. No data about T levels in treated vs. untreated. |
FSCO, focal Sertoli cell only syndrome; HYPO, hypospermatogenesis; ITT, intratesticular testosterone level; MA, maturation arrest; PCNA, proliferating cell nuclear antigen; NA, not applicable; SCO, Sertoli cell only syndrome; SRF, sperm retrieval failure; SSR, successful sperm retrieval.