Abstract: Objective To assess the value of combined evaluation of serum follicle-stimulating hormone (FSH), inhibin B
(INHB), chromosome karyotyping and AZF microdeletion of Y-chromosome (AZF-MD-Ych) in predicting the success of
testicular sperm aspiration (TESA) in azoospermic patients. Methods A total of 262 azoospermic patients were divided into
two groups with normal (n=162) and abnormal (n=100) serum FSH levels. INHB levels, INHB/FSH ratio, chromosome
karyotype patterns of the peripheral lymphocytes, and AZF-MD-Ych were compared between the two groups. Among the
patients receiving TESA, the success rate of the procedure was compared between the two groups after excluding
abnormalities in INHB, chromosome karyotype and AZF-MD-Ych. Results Significant differences were found between the
two groups in serum INHB level, INHB/FSH and chromosome karyotypes (P<0.05), but not in AZF-MD-Ych (P>0.05). After
excluding the abnormalities in chromosome karyotypes, AZF-MD-Ych and INHB, sperms were obtained successfully by TESA
from 61.82% (34/55) of patients with normal FSH but from none of those with abnormal FSH (P<0.01). Conclusion A combined
evaluation of serum FSH, INHB, chromosome karyotypes and AZF-MD-Ych can effectively predict the success of TESA in
azoospermic patients, and abnormalities in all the 4 indices suggest a very low success rate of sperm retrieval by TESA.