Predictive Factors for Successful Testicular Biopsy in Azoospermia

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Published Apr 1, 2026
https://doi.org/10.62438/tunismed.v104i02.6530
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Vol. 104 No. 02 (2026): Tunis Med Fev 2026

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Awatef Raddaoui
Department of Obstetrics and Gynaecology, Tunis Main Military Teaching Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, 1007, Tunis, Tunisia
Omar Abdelhedi
Department of Obstetrics and Gynaecology, Tunis Main Military Teaching Hospital, Faculty of Medicine, University of Sfax, Sfax, Tunisia
Dorra Boujelben
Department of Obstetrics and Gynaecology, Tunis Main Military Teaching Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, 1007, Tunis, Tunisia
Sonia Jalled
Department of Obstetrics and Gynaecology, Tunis Main Military Teaching Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, 1007, Tunis, Tunisia

Abstract

Introduction: Testicular biopsy represents a crucial procedure in the management of non-obstructive azoospermia, though its success remains
variable. Identifying predictive factors for successful sperm retrieval is essential for patient selection.
Aim: To determine the clinical, hormonal and technical factors predictive of successful testicular biopsy in azoospermic patients
Methods: A retrospective analytical study was conducted over 5 years (2017-2021), including 28 patients. Comparative analysis was performed
between groups with successful (spermatozoa present) and failed biopsy.
Results: Significant predictive factors for successful biopsy included: testicular volume preservation (p=0.042), low FSH levels (p=0.002), low
estradiol levels (p=0.018), excretory azoospermia type (p=0.023), and unilateral surgical approach (p=0.005). Clinical varicocele and hydrocele
showed no significant correlation.
Conclusion: Our study identifies a predictive profile for testicular biopsy success, enabling better patient selection and surgical strategy optimization
in assisted reproductive technology.

Keywords:

Testicular biopsy, Azoospermia, Predictive factors, FSH, Spermogram

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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