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Original Research

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Investigating discordance between embryologists and histopathologists: analysis of multiple factors in mTESE sperm retrieval outcomes

Investigando la discordancia entre embriólogos e histopatólogos: análisis de múltiples factores en los resultados de recuperación de esperma mediante mTESE

  • Mehmet Sahin1,*,
  • Osman Can1
  • Emin Taha Keskin1
  • Yigit Can Filtekin1
  • Halil Lutfi Canat1

1Urology Department, University of Health Sciences Basaksehir Cam and Sakura City Hospital, 34480 Istanbul, Turkey

DOI: 10.22514/j.androl.2024.020 Vol.22,Issue 3,September 2024 pp.32-39

Submitted: 09 April 2024 Accepted: 21 June 2024

Published: 30 September 2024

*Corresponding Author(s): Mehmet Sahin E-mail: mehmet.sahin7@saglik.gov.tr

Abstract

The objective of the study is to primarily highlight the consistency between the embryologist and the histopathologist in microdissection testicular sperm extraction and to explore the factors affecting sperm retrieval. The research included 91 patients, aged 20 to 47, who visited our Reproductive Technology center from July 2020 to June 2023. Patient data were collected retrospectively, including demographics, physical exams, lab tests, radiological assessments, genetic analyses, medical histories and histopathological results. Using the Johnsen scoring system for evaluation, the histopathologist identified mature spermatozoa in the specimen in some patients (Johnsen score 8–10); however, the embryologist only declared successful sperm retrieval in 66.6% of them. Overall sperm retrieval rates were lower than expected at 40%. Significant factors influencing sperm retrieval rates included Follicle Stimulating Hormone (p = 0.001), Luteinizing Hormone (p = 0.007), testicular volume (p < 0.001), histopathology (p < 0.001), and alcohol consumption (p = 0.007). A logistic regression model was used to identify the independent predictors of successful sperm retrieval. FSH (p = 0.038), testicular volume (p < 0.001), histopathology (p < 0.001), and alcohol consumption (p = 0.013) emerged as significant predictive factors for the outcome of sperm retrieval. As a result, in addition to patient-related factors, the consistency between the pathologist and embryologist also affects sperm retrieval rates.


Resumen

El objetivo del estudio es destacar principalmente la consistencia entre el embriólogo y el histopatólogo en la extracción de espermatozoides testiculares por microdisección y explorar los factores que afectan la recuperación de espermatozoides. La investigación incluyó a 91 pacientes, de 20 a 47 años, que visitaron nuestro centro de Tecnología Reproductiva desde julio de 2020 hasta junio de 2023. Se recopilaron datos retrospectivamente, incluyendo datos demográficos, exámenes físicos, pruebas de laboratorio, evaluaciones radiológicas, análisis genéticos, historias médicas y resultados histopatológicos. Utilizando el sistema de puntuación de Johnsen para la evaluación, el histopatólogo identificó espermatozoides maduros en la muestra en algunos pacientes (puntuación de Johnsen 8–10); sin embargo, el embriólogo solo declaró recuperación exitosa de espermatozoides en el 66.6% de ellos. En general, las tasas de recuperación de espermatozoides fueron más bajas de lo esperado, con un 40%. Los factores significativos que afectaron las tasas de recuperación de espermatozoides incluyeron Hormona Folículo Estimulante (p = 0.001), Hormona Luteinizante (p = 0.007), volumen testicular (p < 0.001), histopatología (p < 0.001) y consumo de alcohol (p = 0.007). Se utilizó un modelo de regresión logística para identificar los predictores independientes de la recuperación exitosa de espermatozoides. FSH (p = 0.038), volumen testicular (p < 0.001), histopatología (p < 0.001) y consumo de alcohol (p = 0.013) surgieron como factores predictivos significativos para el resultado de la recuperación de espermatozoides. Por lo tanto, además de los factores relacionados con el paciente, la consistencia entre el patólogo y el embriólogo también afecta las tasas de recuperación de espermatozoides.


Keywords

Azoospermia; mTESE; Histopathology; Embriyology; Sperm retrieval


Palabras Clave

Azoospermia; mTESE; Histopatología; Embriología; Recuperación espermática


Cite and Share

Mehmet Sahin,Osman Can,Emin Taha Keskin,Yigit Can Filtekin,Halil Lutfi Canat. Investigating discordance between embryologists and histopathologists: analysis of multiple factors in mTESE sperm retrieval outcomesInvestigando la discordancia entre embriólogos e histopatólogos: análisis de múltiples factores en los resultados de recuperación de esperma mediante mTESE. Revista Internacional de Andrología. 2024. 22(3);32-39.

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