Objective: To validate factors predictive of nonobstructive azoospermia (NOA) and to determine the operating characteristics of FSH for predicting NOA.
Design: Retrospective cohort study.
Setting: Tertiary care military treatment facility.
Patient(s): One hundred forty azoospermic males undergoing infertility evaluation.
Intervention(s): Standard evaluation included history and physical, hormonal workup, and genetic evaluation. Diagnostic testicular biopsy was offered to characterize patients as obstructive azoospermia (OA) or NOA.
Main outcome measure(s): Semen volume, semen fructose, FSH, T, E₂, PRL, testicular atrophy.
Result(s): Seventy-eight of 140 azoospermic patients underwent a biopsy. The ability to predict NOA based on logistic regression was statistically significant for FSH and testicular atrophy. On multivariate analysis, only FSH remained predictive of NOA. The area under the FSH receiver operating characteristic curve was 0.847, which is significant. The cut point of FSH with the highest likelihood ratio of predicting NOA on biopsy was ≥12.3 mIU/mL.
Conclusion(s): FSH remains the best predictor of NOA. With full knowledge of the operating characteristics of FSH in this population, a patient can be properly educated and treatment can be individualized, based on the specific risk associated with that subject's measured FSH.
Keywords: Follicle stimulating hormone; azoospermia; infertility; operating characteristics.
Published by Elsevier Inc.