Changes in testosterone levels following surgical sperm retrieval in men with non-obstructive azoospermia: systematic review and meta-analysis

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dc.contributor.authorZohdy, Wael
dc.contributor.authorShah, Rupin
dc.contributor.authorHo, Christopher Chee Kong
dc.contributor.authorÇalık, Gökhan
dc.contributor.authorMalhotra, Vineet
dc.contributor.authorKolbaşı Erkan, Bircan
dc.contributor.authorAgarwal, Ashok
dc.date.accessioned2025-10-01T06:49:50Z
dc.date.available2025-10-01T06:49:50Z
dc.date.issued2025
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Histoloji ve Embriyoloji Ana Bilim Dalı
dc.description.abstractPurpose: Surgical sperm retrieval (SSR) is used to extract spermatozoa for use with intracytoplasmic sperm injection in men with obstructive and non-obstructive azoospermia (NOA). The procedure may lead to segmental devascularization, postoperative fibrosis, and atrophy with a subsequent decrease in testosterone. The aim of the study is to investigate the impact of SSR on serum levels of total testosterone (TT), follicle-stimulating hormone (FSH), luteinizing hormone (LH) testicular volume, and sexual function in infertile azoospermic men. Materials and Methods: In this systematic review and meta-analysis (SRMA), we searched articles in “PubMed” and “Scopus” exploring the impact of SSR on TT, FSH, LH, and testicular volume. The full-text articles were screened to assess eligibility before data extraction, quality assessment, and meta-analysis. Results: Seventeen studies meeting the inclusion criteria were finally analyzed and included 1,685 infertile, azoospermic men. Patients underwent SSR and were followed in the postoperative period (one week to 32 months). The analysis showed a significant reduction in TT (mean difference [MD] 3.81 nmol/L, 95% confidence interval [CI] 0.55:7.06; p=0.02) compared to pre-SSR values. We also observed insignificant differences in serum FSH (MD 5.08 IU/L, 95% CI -5.6:15.8; p=0.35), LH (MD -2.96 IU/L, 95% CI -6.31:0.39; p=0.08), and no change in testicular volume (MD 0.07 mL, 95% CI -1.92:2.07; p=0.94) after SSR. Sexual dysfunction was associated with hypogonadism, depression, and anxiety, especially in men with unsuccessful SSR and Klinefelter syndrome. Conclusions: The results of this SRMA indicate a significant reduction in TT after SSR. Sexual dysfunction after testicular sperm extraction and the potential negative impact of future SSR repeat should be considered during preoperative counseling.
dc.identifier.citationZohdy, W., Shah, R., Ho, C. C. K., Çalık, G., Malhotra, V., Kolbaşı Erkan, B. ... Agarwal, A. (2025). Changes in testosterone levels following surgical sperm retrieval in men with non-obstructive azoospermia: systematic review and meta-analysis. World Journal of Men's Health, 43(3), 523-538. http://dx.doi.org/10.5534/wjmh.240129
dc.identifier.doi10.5534/wjmh.240129
dc.identifier.endpage538
dc.identifier.issn2287-4208
dc.identifier.issn2287-4690
dc.identifier.issue3
dc.identifier.pmid39344115
dc.identifier.scopus2-s2.0-105015323239
dc.identifier.scopusqualityQ1
dc.identifier.startpage523
dc.identifier.urihttp://dx.doi.org/10.5534/wjmh.240129
dc.identifier.urihttps://hdl.handle.net/20.500.12511/13062
dc.identifier.volume43
dc.identifier.wosWOS:001321298300001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÇalık, Gökhan
dc.institutionauthorKolbaşı Erkan, Bircan
dc.institutionauthorid0000-0002-9976-9666
dc.institutionauthorid0000-0001-7933-4262
dc.language.isoen
dc.relation.ispartofWorld Journal of Men's Health
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsAttribution-NonCommercial 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectAzoospermia
dc.subjectHypogonadism
dc.subjectMicrosurgical Testicular Sperm Retrieval
dc.subjectSperm Injections
dc.subjectIntracytoplasmic
dc.subjectTesticular Sperm Extraction
dc.titleChanges in testosterone levels following surgical sperm retrieval in men with non-obstructive azoospermia: systematic review and meta-analysis
dc.typeArticle

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