Author/Authors :
Chehrazi، Mohammad نويسنده Department of biostatistics and epidemiology, Tehran university of medical sciences, Tehran, Iran , , Rahimiforoushani، Abbas نويسنده Department of Epidemiology and Statistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran , , Sabbaghian، Marjan نويسنده Department of Andrology, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , , Nourijelyani، Keramat نويسنده , , Sadighi Gilani، Mohammad Ali نويسنده Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , , Hoseini، Mostafa نويسنده Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran , , Vesali، Samira نويسنده Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran , , Yaseri، Mehdi نويسنده Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran , , Alizadeh ، Ahad نويسنده Department of Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran Alizadeh , Ahad , Mohammad، Kazem نويسنده , , Omani Samani، Reza نويسنده ,
Abstract :
Background: The most common chromosomal abnormality due to non-obstructive azoospermia
(NOA) is Klinefelter syndrome (KS) which occurs in 1-1.72 out of 500-1000
male infants. The probability of retrieving sperm as the outcome could be asymmetrically
different between patients with and without KS, therefore logistic regression analysis is
not a well-qualified test for this type of data. This study has been designed to evaluate
skewed regression model analysis for data collected from microsurgical testicular sperm
extraction (micro-TESE) among azoospermic patients with and without non-mosaic KS
syndrome.
Materials and Methods: This cohort study compared the micro-TESE outcome between
134 men with classic KS and 537 men with NOA and normal karyotype who were referred
to Royan Institute between 2009 and 2011. In addition to our main outcome, which
was sperm retrieval, we also used logistic and skewed regression analyses to compare the
following demographic and hormonal factors: age, level of follicle stimulating hormone
(FSH), luteinizing hormone (LH), and testosterone between the two groups.
Results: A comparison of the micro-TESE between the KS and control groups showed
a success rate of 28.4% (38/134) for the KS group and 22.2% (119/537) for the control
group. In the KS group, a significantly difference (P < 0.001) existed between testosterone
levels for the successful sperm retrieval group (3.4 ± 0.48 mg/mL) compared to the
unsuccessful sperm retrieval group (2.33 ± 0.23 mg/mL). The index for quasi Akaike
information criterion (QAIC) had a goodness of fit of 74 for the skewed model which was
lower than logistic regression (QAIC=85).
Conclusion: According to the results, skewed regression is more efficient in estimating
sperm retrieval success when the data from patients with KS are analyzed. This finding
should be investigated by conducting additional studies with different data structures.
