Hypogonadism post TESE: how much is it really worrying?
Sacca, A1; La Croce, G2; Manica, M1; Nicolai, M1; Angiolilli, D1; Naspro, RL1; Roscigno, M1; Rocchini, L1; Castellucci, E1; Deiana, G1; Belussi, D1; Pellucchi, F1; Da Pozzo, LF1
1: ASST PAPA GIOVANNI XXIII, BERGAMO, Italy; 2: ASST PAPA GIOVANNI XXIII, BERGAMO, ITALY
Objective: Few studies of the post-TESE endocrinologic course have been reported in the current literature. In this prospective study we report the occurrence of hypogonadism after testicular sperm retrevial in no obstructive azoospermia (NOA) patients treated in a non academic centre.
Material and Methods: Complete data of 110 consecutive Caucasian males, suffering from primary infertility, were collected between January 2013 to October 2017. All patients were referred to our center for TESE, conventional (c-TESE) or microscopic (m-TESE); all procedures were performed by the same surgeon (AS). We reported hormone profiles before surgery and 3 months after the procedure. Moreover, we divided the population in order to find a possible correlation between type of procedure and postoperative hypogonadism. Descriptive statistic was used to describe population features. Chi-square and ANOVA test were used to examine the differences in categorical and continuous variables, respectively.
Results: A hundred and ten pts with a median age of 37 (range 26-53) years were included in the present study. Regarding the cause of primary infertility, 70 out of 110 pts (49.2%) were NOA. Considering NOA pts serum preoperative hormone levels were: FSH level median 12 mUI/mL (range 1.2-62.2), median LH 6.5 mUI/mL (1.6-38.6), median prolactin 12.1 ng/mL (4.5-22.4), median total testosterone 4.49 ng/mL (1.0-10.4). Total sperm retrieval rate (SRR) for NOA group was 48.4%. Consensual testicular biopsy was performed in all pts. 3 months post operative hormone levels were: FSH level median 12.7 mUI/mL (range 1.4-62.8), median LH 6.9 mUI/mL (2.1-39.5), median prolactin 12.4 ng/mL (4.9-22.8), median total testosterone 4.12 ng/mL (1.0-9.8). At Chi Square analysis no statistically significant differences (all p > 0.2) were found between hormone profiles before and 3months after surgery. The technique (c-TESE or m-TESE) does not impact on the post operative serum testosterone concentration (p= 0.1).
Conclusions: In our study TESE procedures did not cause a significant decrease of post operative hormone profiles, specially for testosterone level. Post operative serum testosterone concentrations are similar between patients in the c-TESE and m-TESE groups. No pts demonstrated symptoms of low testosterone level.
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