Operating characteristics of follicle-stimulating hormone in azoospermic men

In a retrospective cohort study of azoospermic patients, the full operating characteristics of follicle stimulating hormone were determined to allow for proper education of patients and individualized treatment based on specific risk.

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Authors

Matthew S. Christman, M.D., Suzanne R. Gudeman, M.D., Justin J. Nork, D.O., Rustin C. Walters, M.D., James O. L’Esperance, M.D., Donald S. Crain, M.D.

Volume 101, Issue 5, Pages 1261–1265

Abstract

Objective:

To validate factors predictive of nonobstructive azoospermia (NOA) and to determine the operating characteristics of FSH for predicting NOA.

Design:

Retrospective cohort study.

Setting:

Tertiary care military treatment facility.

Patient(s):

One hundred forty azoospermic males undergoing infertility evaluation.

Intervention(s):

Standard evaluation included history and physical, hormonal workup, and genetic evaluation. Diagnostic testicular biopsy was offered to characterize patients as obstructive azoospermia (OA) or NOA.

Main Outcome Measure(s):

Semen volume, semen fructose, FSH, T, E2, PRL, testicular atrophy.

Result(s):

Seventy-eight of 140 azoospermic patients underwent a biopsy. The ability to predict NOA based on logistic regression was statistically significant for FSH and testicular atrophy. On multivariate analysis, only FSH remained predictive of NOA. The area under the FSH receiver operating characteristic curve was 0.847, which is significant. The cut point of FSH with the highest likelihood ratio of predicting NOA on biopsy was ≥12.3 mIU/mL.

Conclusion(s):

FSH remains the best predictor of NOA. With full knowledge of the operating characteristics of FSH in this population, a patient can be properly educated and treatment can be individualized, based on the specific risk associated with that subject’s measured FSH.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00082-X/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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