The Value of Serum Follicle-Stimulating Hormone in Predicting Successful Surgical Sperm Retrieval in Cases of Male Infertility: A Literature Review

Abstract

Azoospermia is a common cause of male infertility; however, surgical sperm retrieval (SSR) and subsequent intracytoplasmic sperm injection offers couples the chance to have a biological child. SSR success is highly variable and dependent on a number of factors. One such factor is male follicle-stimulating hormone (FSH), which has been researched extensively. The aim of this literature review is to ascertain if there is a ‘cut off’ FSH value that correlates with successful SSR, whether this value differs depending on method of SSR, and if there is a correlation between male FSH level and obstetric outcomes. Thirty-five articles were identified and reviewed, with 10 papers suggesting FSH cut off values. These ranged from <8.5 to <25.0 IU/L, with a mean value of 14.0 IU/L. Generally the results suggested that lower FSH values were associated with increased SSR success. Few papers considered pregnancy and birth outcomes following intracytoplasmic sperm injection with surgically retrieved sperm, and there was no clear correlation with male FSH levels. Clinical implications include considering FSH results when counselling patients about both SSR and intracytoplasmic sperm injection. Suggested future research implications are to further investigate the predictive role of FSH in combination with other clinical and endocrinological markers.