The effect of discordance between embryologist and pathologist on sperm retrieval rates in patients with non-obstructive azoospermia undergoing mTESE

Abstract This study investigates predictive factors, specifically the consistency between embryologist and pathologist, influencing sperm retrieval rates in microdissection testicular sperm extraction for non-obstructive azoospermia. The research involved 91 patients aged 20 to 47, who applied to our Reproductive Technology center from July 2020 to June 2023. Patient data, including demographics, physical exams, lab tests, radiological assessments, genetic analyses, medical histories, and histopathological results, were retrospectively collected. Different than literature findings, cases were identified where histopathology showed spermatozoa, yet microdissection testicular sperm extraction yielded unsuccessful sperm retrieval. The Johnsen score was categorized into three groups: spermatozoa found (Group I), maturation arrest (Group II), and no spermatogenesis (Group III). In Group I, despite pathologist-identified spermatozoa, only 66.6% were deemed successful sperm retrieval by the embryologist. Overall sperm retrieval rates were lower than expected at 39.56%. A logistic regression model was employed to determine the independent predictors of positive sperm retrieval. In this analysis, FSH levels, testicular volume, histopathological findings, and alcohol consumption emerged as significant predictive factors for the outcome of sperm retrieval. As a result, in addition to these patient-related factors, the consistency between the pathologist and histologist is also important.