Presentation Authors: Shoichiro Iwatsuki*, Tomoki Takeda, Satoshi Nozaki, Takahiro Kobayashi, Yasue Kubota, Hiroki Kubota, Hiroyuki Kamiya, Yukihiro Umemoto, Takahiro Yasui, Nagoya, Japan
Introduction: We previously reported that seminiferous tubular atrophy and lamina propria thickening progresses with aging in men with azoospermia (MP07-12, AUA Annual Meeting 2016). However, the relationship between aging and treatment outcome of azoospermia is unclear. In this study, we report the sperm retrieval rate (SRR) in relation to the age of patients with nonobstructive azoospermia (NOA).
Methods: The 239 patients with idiopathic NOA enrolled in this study were divided according to age into the following three age groups: 20s ( < 30 years, n = 39), 30s (30 to 40 years, n = 163), and >40s (>40 years, n = 37). For each group, the average testicular volume, levels of serum luteinizing hormone, follicle-stimulating hormone, and total testosterone (TT), SRR, and the incidence of hyalinized tubules and infiltration of inflammatory cells in the testicular biopsy specimens were compared. For statistical analysis, the Jonckheere-Terpstra and Cochran-Armitage tests were used.
Results: The results are summarized in the table. Testicular volume tended to decrease (p < 0.01) and gonadotropins, but not TT, tended to increase (p < 0.05) with age. SRR tended to be higher in the older age groups, but this finding was not statistically significant. In addition, the incidence of hyalinized tubules and inflammatory cell infiltration in the biopsy specimens was significantly higher in the older age groups (p < 0.01).
Conclusions: Our results indicate that the chance of sperm retrieval is favorable despite the age of older patients. However, we also clarified that tubular hyalinization and inflammatory cell infiltration was more frequently seen in testes of older NOA patients, suggesting that tubular atrophy progresses with aging. Thus, we propose that early planning for sperm retrieval is necessary to avoid progression of testicular degeneration.