In search of the surgical sperm cell: Do we have to perform a testicular biopsy systematically? [à la recherche du spermatozo?de chirurgical : Doit-on effectuer une biopsie testiculaire systématique ?]

摘要

Introduction: Testicular biopsies are diagnostic and therapeutic tools involved in male infertility care. However, this surgery is invasive and not systematically successful. We studied the preoperative clinical and hormonal factors allowing to predict the obtaining of sperm cells. Patients and methods: A retrospective study was conducted on 209 patients who all had a testicular biopsy for procreation medically assisted (PMA). The studied criteria were: the age at the time of the surgery, the male cause of the infertility, the testicular volume, the tobacco smoking exposure, the concentrations of estradiol, FSH, LH, prolactin, and testosterone. The comparison of both groups (successful biopsy versus failed biopsy) was made in bivariate analysis then in multivariate analysis. Results: The testicular volume average and the cause were the two only factors which had a real influence on the negativity of the biopsy. In it was added in bivariate analysis a statistically significant correlation of the smoking exposure and the FSH with the failed biopsy. Discussion: The existence of these factors, and their accumulation, was strongly predictive of a failure of the biopsy. However, we found germ cells in patients exposed to the studied factors, letting think that it is systematically necessary to propose the surgery at the risk of a limited profit.