Relationship between pre-micro-TESE serum anti-Müllerian hormone (AMH) levels and sperm retrieval success in patients diagnosed with non-obstructive azoospermia: A retrospective study

Objective: We aimed to evaluate the relationship between serum anti-Müllerian hormone (AMH) levels measured before microdissection testicular sperm extraction (mTESE) and sperm retrieval (SR) success in men diagnosed with non-obstructive azoospermia (NOA). Materials and Methods: The present study was based on retrospective evaluation of 58 patients who presented to our clinic between January 2025 and April 2026, were diagnosed with NOA, and underwent mTESE. Patient age, duration of infertility, serum AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH) testosterone levels, and the AMH/testosterone ratio were recorded. Demographic and hormonal parameters were compared between the successful SR (+SR) and unsuccessful SR (-SR) groups after mTESE. Results: The mean age of the study population (n=58) was 35.53±6.10 years, and the mean infertility duration was 8.25±4.53 years. The mean serum AMH level was 2.42±2.35 ng/mL (median: 2.14 ng/mL; range: 0.01-9.87 ng/mL). +SR was achieved in 29 patients (50%), whereas no sperm could be retrieved in the remaining 29 patients (50%). Comparison of two groups revealed no statistically significant difference between the sperm-positive and sperm-negative groups with respect to age, duration of infertility, AMH, FSH, LH, testosterone, or the AMH/testosterone ratio. Receiver operating characteristic analysis revealed an area under the curve value of 0.531 for AMH (95% confidence interval: 0.379-0.683, p=0.690), indicating no significant predictive value. Binomial logistic regression analysis also found no variable to be a significant predictor of +SR. Conclusion: Serum AMH level, either alone or in combination with other hormonal parameters, was not found to be a reliable clinical biomarker for predicting SR outcomes in men with NOA undergoing mTESE. Larger, prospective, etiologically stratified studies are required to determine the definitive role of AMH in preoperative evaluation.