Background: Infertility affects 10-15% of couples, with both male and female factors contributing. Non-obstructive azoospermia (NOA) causes 60% of azoospermia cases, and micro-TESE with ICSI is a key treatment. Hormonal stimulation before micro-TESE may improve sperm retrieval, though its effectiveness is debated.
Objectives: To compare the efficacy of administering HCG and AEI before performing microscopic testicular sperm extraction
Patients and methods: This study involved 120 male patients with NOA from South Valley University Hospitals. Participants were randomly assigned into three groups: Group 1 received HCG treatment, Group 2 received aromatase enzyme inhibitors, and Group 3 was a control group with no treatment. All patients underwent a thorough evaluation. Microdissection TESE was performed, and postoperative data was compared between the 3 groups.
Results: The study compared demographic and clinical characteristics among three groups: HCG, AEI, and Control. No significant differences were observed in age, testicular volume, varicocele prevalence, or hormone levels. However, significant differences were found in sperm retrieval outcomes: 25% of the HCG group, 35% of the AEI group, and 80% of the Control group had no sperm retrieved (p<0.001). Moderate sperm concentration was significantly higher in the AEI group (20%) compared to HCG (5%) and Control (0%) (p=0.003), while good sperm concentration was higher in the HCG group (40%) compared to AEI (25%) and Control (0%) (p<0.001). No significant differences were found in ICSI usage across groups (p=0.857).
Conclusion: HCG and AEI prior to micro-TESE improves testosterone levels and sperm retrieval outcomes in men with NOA.