Imperial College London
Alternate

Dr. Channa Jayasena MA PhD MRCP FRCPath

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Reader in Reproductive Endocrinology
 
 
 
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Contact

 

c.jayasena Website

 
 
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Location

 

6N5CCommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Tharakan:2022:humupd/dmac016,
author = {Tharakan, T and Corona, G and Foran, D and Salonia, A and Sofikitis, N and Giwercman, A and Krausz, C and Yap, T and Jayasena, CN and Minhas, S},
doi = {humupd/dmac016},
journal = {Human Reproduction Update},
pages = {609--628},
title = {Does hormonal therapy improve sperm retrieval rates in men with non-obstructive azoospermia: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1093/humupd/dmac016},
volume = {28},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUNDThe beneficial effects of hormonal therapy in stimulating spermatogenesis in patients with non-obstructive azoospermia (NOA) and either normal gonadotrophins or hypergonadotropic hypogonadism prior to surgical sperm retrieval (SSR) is controversial. Although the European Association of Urology guidelines state that hormone stimulation is not recommended in routine clinical practice, a significant number of patients undergo empiric therapy prior to SSR. The success rate for SSR from microdissection testicular sperm extraction is only 40–60%, thus hormonal therapy could prove to be an effective adjunctive therapy to increase SSR rates.OBJECTIVE AND RATIONALEThe primary aim of this systematic review and meta-analysis was to compare the SSR rates in men with NOA (excluding those with hypogonadotropic hypogonadism) receiving hormone therapy compared to placebo or no treatment. The secondary objective was to compare the effects of hormonal therapy in normogonadotropic and hypergonadotropic NOA men.SEARCH METHODSA literature search was performed using the Medline, Embase, Web of Science and Clinicaltrials.gov databases from 01 January 1946 to 17 September 2020. We included all studies where hormone status was confirmed. We excluded non-English language and animal studies. Heterogeneity was calculated using I2 statistics and risk of bias was assessed using Cochrane tools. We performed a meta-analysis on all the eligible controlled trials to determine whether hormone stimulation (irrespective of class) improved SSR rates and also whether this was affected by baseline hormone status (hypergonadotropic versus normogonadotropic NOA men). Sensitivity analyses were performed when indicated.OUTCOMESA total of 3846 studies were screened and 22 studies were included with 1706 participants. A higher SSR rate in subjects pre-treated with hormonal therapy was observed (odds ratio (OR) 1.96, 95% CI: 1.08–3.56, P = 0.03) and this trend persisted when e
AU  - Tharakan,T
AU  - Corona,G
AU  - Foran,D
AU  - Salonia,A
AU  - Sofikitis,N
AU  - Giwercman,A
AU  - Krausz,C
AU  - Yap,T
AU  - Jayasena,CN
AU  - Minhas,S
DO  - humupd/dmac016
EP  - 628
PY  - 2022///
SN  - 1355-4786
SP  - 609
TI  - Does hormonal therapy improve sperm retrieval rates in men with non-obstructive azoospermia: a systematic review and meta-analysis
T2  - Human Reproduction Update
UR  - http://dx.doi.org/10.1093/humupd/dmac016
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000791961300001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://academic.oup.com/humupd/advance-article/doi/10.1093/humupd/dmac016/6582352?searchresult=1&login=true
UR  - http://hdl.handle.net/10044/1/98908
VL  - 28
ER  -
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