Anti-Mullerian hormone level as a predictor of sperm retrieval with microdissection testicular sperm extraction in nonobstructive azoospermia

Limited factors effectively predict sperm retrieval with microdissection testicular sperm extraction in men with nonobstructive azoospermia. We therefore sought to evaluate the role of serum anti-Mullerian hormone as a predictive biomarker for successful sperm retrieval. We included patients with pre-operative anti-Mullerian hormone levels and stratified them based on prior history of prior sperm retrieval procedure. We compared hormone levels between those who did and did not have a successful sperm retrieval and used receiver operating curves to determine an optimal cut-off value. A total of 46 men were included, of whom 18 (39.1%) had no prior sperm retrieval and 11 (61.1%) had sperm successfully retrieved. Pre-operative serum anti-Mullerian hormone levels were predictive of sperm retrieval in patients with no prior attempts at retrieval (p = .03). Receiver operating curve for those without prior retrieval was 0.6753. The optimal anti-Mullerian hormone cut-off for those without prior sperm retrieval was 0.133 ng/ml with a sensitivity of 0.91 and specificity of 0.29. Therefore, serum anti-Mullerian hormone levels have modest predictive value for sperm retrieval in this cohort. The combination of clinical history, examination and laboratory investigations should continue to be used to guide surgeons in counselling patients regarding the chance of sperm retrieval.

Automated summary

This study found that serum anti-Mullerian hormone levels have modest predictive value for sperm retrieval in men with nonobstructive azoospermia. For patients without prior sperm retrieval attempts, a cut-off of 0.133 ng/ml for anti-Mullerian hormone showed a sensitivity of 0.91 and specificity of 0.29.