A step closer to parenthood with non-obstructive azoospermia: Unveiling the impact of microdissection testicular sperm extraction in Australia's largest single-centre study

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-02-17 DOI:10.1111/ajo.13800

Hossam Elzeiny, Franca Agresta, John Stevens, David K. Gardner

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Abstract

Background

Non-obstructive azoospermia (NOA) diagnosis poses challenges for couples seeking parenthood. Microdissection testicular sperm extraction (MD-TESE) excels in retrieving testicular sperm cells for NOA cases. However, limited live birth data in Australian NOA patients hinders accurate counselling.

Aims

This study aimed to determine the likelihood of infertile couples with a male partner diagnosed with NOA conceiving biological children using MD-TESE / intracytoplasmic sperm injection (ICSI).

Materials and methods

A retrospective cohort study included 108 NOA men treated at a public fertility unit and a private fertility centre (May 2009–May 2022). Primary outcome: live birth rate (LBR); secondary outcomes: sperm retrieval rate, pregnancy rate, and neonatal outcomes.

Results

Among 108 patients undergoing MD-TESE, the positive sperm retrieval rate (PSRR) was 64.8% (70/108). Histology best predicted sperm retrieval success, with hypo-spermatogenesis yielding a 94.1% PSRR. Age, testicular volume, and hormonal parameters had no significant impact. Mean male age: 35.4 years; mean partner age: 32.7 years. Fertilisation rate: 50.7%. LBR per initiated cycle: 58.7% (37/63); per embryo transfer: 63.8% (37/58); per initially diagnosed NOA man: 34.3% (37/108). Cumulative LBR: 74.1% (43/58); twin rate: 10.8% (4/37). No neonatal deaths or defects were observed among 47 live offspring.

Conclusion

This study provides valuable data for counselling NOA couples on the probability of conceiving biological offspring. MD-TESE and ICSI yielded favourable PSRR (64.8%) and LBR (63.8%). However, couples should be aware that once NOA is confirmed, the chance of taking home a baby is 34%.

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非梗阻性无精子症患者离为人父母更近了一步：在澳大利亚最大的单中心研究中揭示显微解剖睾丸取精术的影响。

背景：非梗阻性无精子症（NOA）的诊断为寻求生育的夫妇带来了挑战。显微解剖睾丸精子提取术（MD-TESE）在提取无精子症病例的睾丸精子细胞方面表现出色。目的：本研究旨在确定男性伴侣被诊断为NOA的不育夫妇通过MD-TESE/卵胞浆内单精子显微注射（ICSI）怀上亲生子女的可能性：主要结果：活产率（LBR）；次要结果：取精率、妊娠率和新生儿结局：在 108 名接受 MD-TESE 的患者中，阳性取精率为 64.8%（70/108）。组织学最能预测取精成功率，低精子生成率为 94.1%。年龄、睾丸体积和激素参数没有明显影响。男性平均年龄：35.4 岁；伴侣平均年龄：32.7 岁。受精率50.7%.每个启动周期的 LBR58.7% (37/63)；每次胚胎移植：63.8% (37/58)；每名最初诊断为 NOA 的男性：34.3% (37/108)。累积 LBR：74.1%（43/58）；双胎率：10.8%（4/37）：10.8% (4/37).47 名活产后代中未发现新生儿死亡或缺陷：这项研究为向 NOA 夫妇提供有关怀上亲生后代概率的咨询提供了有价值的数据。MD-TESE和ICSI的PSRR（64.8%）和LBR（63.8%）结果良好。然而，夫妇们应该意识到，一旦确认无精子症，带回一个孩子的几率只有 34%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian & New Zealand Journal of Obstetrics & Gynaecology 医学-妇产科学

CiteScore

3.40

自引率

11.80%

发文量

165

审稿时长

4-8 weeks

期刊介绍： The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.