Received July 21, 2011
Accepted August 02, 2011

Objective: To evaluate the prognostic value of testicular histology on sperm retrieval success and intracytoplasmic sperm injection (ICSI) outcomes. Methods: Sixty couples undergoing testicular sperm aspiration (TESA) for ICSI were divided into three groups according to their testicular histopathological diagnosis: (i) Hypospermatogenesis (HS, N=24), (ii) Maturation arrest (MA, N=17), and (iii) Sertoli-cell-only syndrome (SCOS, N=19). Sperm retrieval success and ICSI outcomes were compared. The relationship between histological diagnosis and (i) serum FSH value and (ii) testicular volume was also investigated. Results: Sperm retrieval rate (HS: 91.6%, MA: 35.2% and SCOS: 26.3%, p<0.001) and fertilization rate (HS: 69.9%, MA: 49.3%, and SCOS: 43.3%, p=0.048) were significantly higher in HS group. A trend towards a higher percentage of high-quality embryos was noted in HS group (HS: 55.0%, MA: 31.0% and SCOS: 30.9%, p=0.076). No differences in testicular volume were observed. Nevertheless, FSH value was significantly higher in SCOS patients (HS: 10.2±5.4 mIU/mL, MA: 9.9±6.8 mIU/mL, and SCOS: 26.1±15.3 mIU/mL, p< 0.01). Conclusions: Histological findings present in testicular biopsy specimens of NOA patients were able to predict sperm retrieval success and ICSI outcomes. An elevated serum FSH level is significantly correlated with SCOS presence in azoospermic patients.