We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate （SRR） of microdissection testicular sperm extraction （TESE） in patients with nonobstructive azoo...We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate （SRR） of microdissection testicular sperm extraction （TESE） in patients with nonobstructive azoospermia （NOA）. All relevant studies were searched in PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO. We chose three parameters to perform the meta-analysis： follicle-stimulating hormone （FSH）, testicular volume, and testicular histopathological findings which included three patterns： hypospermatogenesis （HS）, maturation arrest （MA）, and Sertoli-cell-only syndrome （SCOS）. If there was a threshold effect, only the area under the summary receiver operating characteristic curve （AUSROC） was calculated. Otherwise, the pooled sensitivity, specificity, positive likelihood ratio （PLR）, negative likelihood ratio （NLR）, and the diagnostic odds ratio （DOR） were also calculated. Twenty-one articles were included in our study finally. There was a threshold effect among studies investigating FSH and SCOS. The AUSROCs of FSH, testicular volume, HS, MA, and SCOS were 0.6119, 0.6389, 0.6758, 0.5535, and 0.2763, respectively. The DORs of testicular volume, HS, and MA were 1.98, 16.49, and 1.26, respectively. The sensitivities of them were 0.80, 0.30, and 0.27, while the specificities of them were 0.35, 0.98, and 0.76, respectively. The PLRs of them were 1.49, 10.63, and 1.15, respectively. And NLRs were 0.73, 0.72, and 0.95, respectively. All the investigated factors in our study had limited predictive value. However, the histopathological findings were helpful to some extent. Most patients with HS could get sperm by microdissection TESE.展开更多
Saad et al.'s review~([1]),“Emerging trends in the management of non-obstructive azoospermia,”offers a compelling synthesis of cutting-edge diagnostic and therapeutic strategies for non-obstructive azoospermia(N...Saad et al.'s review~([1]),“Emerging trends in the management of non-obstructive azoospermia,”offers a compelling synthesis of cutting-edge diagnostic and therapeutic strategies for non-obstructive azoospermia(NOA),a challenging condition affecting 10%–15%o infertile men.By highlighting advances in whole exome sequencing(WES),biomarkers like Anti-Müllerian hormone(AMH)and microRNAs(miRNAs),and microdissection testicular sperm extraction(micro-TESE),the authors chart a path toward precision medicine in male infertility.Their exploration of AI and gene-editing technologies like CRISPR/Cas9 underscores the transformative potential of these innovations.展开更多
文摘We performed this meta-analysis to evaluate the predictive value of different parameters in the sperm retrieval rate （SRR） of microdissection testicular sperm extraction （TESE） in patients with nonobstructive azoospermia （NOA）. All relevant studies were searched in PubMed, Web of Science, EMBASE, Cochrane Library, and EBSCO. We chose three parameters to perform the meta-analysis： follicle-stimulating hormone （FSH）, testicular volume, and testicular histopathological findings which included three patterns： hypospermatogenesis （HS）, maturation arrest （MA）, and Sertoli-cell-only syndrome （SCOS）. If there was a threshold effect, only the area under the summary receiver operating characteristic curve （AUSROC） was calculated. Otherwise, the pooled sensitivity, specificity, positive likelihood ratio （PLR）, negative likelihood ratio （NLR）, and the diagnostic odds ratio （DOR） were also calculated. Twenty-one articles were included in our study finally. There was a threshold effect among studies investigating FSH and SCOS. The AUSROCs of FSH, testicular volume, HS, MA, and SCOS were 0.6119, 0.6389, 0.6758, 0.5535, and 0.2763, respectively. The DORs of testicular volume, HS, and MA were 1.98, 16.49, and 1.26, respectively. The sensitivities of them were 0.80, 0.30, and 0.27, while the specificities of them were 0.35, 0.98, and 0.76, respectively. The PLRs of them were 1.49, 10.63, and 1.15, respectively. And NLRs were 0.73, 0.72, and 0.95, respectively. All the investigated factors in our study had limited predictive value. However, the histopathological findings were helpful to some extent. Most patients with HS could get sperm by microdissection TESE.
文摘Saad et al.'s review~([1]),“Emerging trends in the management of non-obstructive azoospermia,”offers a compelling synthesis of cutting-edge diagnostic and therapeutic strategies for non-obstructive azoospermia(NOA),a challenging condition affecting 10%–15%o infertile men.By highlighting advances in whole exome sequencing(WES),biomarkers like Anti-Müllerian hormone(AMH)and microRNAs(miRNAs),and microdissection testicular sperm extraction(micro-TESE),the authors chart a path toward precision medicine in male infertility.Their exploration of AI and gene-editing technologies like CRISPR/Cas9 underscores the transformative potential of these innovations.
