Does ICSI outcome in obstructive azoospermia differ according to the origin of retrieved spermatozoa or the cause of epididymal obstruction? A comparative study

Author:

Yu Xiaochen,Lu Shaoming,Yuan Mingzhen,Ma Gang,Li Xiao,Zhang Taijian,Gao Shanshan,Wei Daimin,Chen Zi-Jiang,Liu HongbinORCID,Zhang Haobo

Abstract

Abstract Purpose To determine whether ICSI outcomes are affected by sperm source or genital tract inflammatory status. Methods A retrospective cohort study was conducted in all consecutive obstructive azoospermia patients who underwent testicular sperm aspiration (TESA) or percutaneous epididymal sperm aspiration (PESA) and ICSI between February 1, 2017, and December 31, 2020. Couples were excluded if they were diagnosed with monogenic disease, abnormal karyotype, or had female uterine malformation. The primary objective was to determine whether ICSI outcomes are affected by the use of testicular or epididymal spermatozoa, and the secondary objective was to explore the effect of granulocyte elastase on ICSI outcomes using epididymal spermatozoa. Results Compared with TESA, inflammatory and non-inflammatory PESA patients exhibited a better high-quality embryo rate, with significant differences among the three groups (49.43 vs. 55.39% and 56.03%; odds ratio, 6.345 and 6.631; 95% confidence interval, 0.340–12.350, and 1.712–11.550; P = 0.038 and P = 0.008, respectively). The fertilization rate, clinical pregnancy rate, live birth delivery rate, and congenital anomaly birth rate were similar in patients who underwent TESA or PESA (with or without inflammation). Conclusions The high-quality embryo rate in PESA patients was higher than that in TESA patients. After successful pregnancy, ICSI outcomes did not differ between patients with obstructive azoospermia who experienced TESA or PESA and those with or without genital tract inflammation.

Funder

Basic Science Center Program of NSFC

Major Innovation Projects in Shandong Province

the Science Foundation for Distinguished Yong Scholars of Shandong

the Key Research and Development Program of Shandong Province

Taishan Scholars Program for Young Experts of Shandong Province

Key Laboratory of Sedimentary Mineralization and Sedimentary Minerals in Shandong Province

Publisher

Springer Science and Business Media LLC

Subject

Urology,Nephrology

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