How successful is TESE-ICSI in couples with non-obstructive azoospermia?

Vloeberghs, Veerle; Verheyen, Greta; Haentjens, Patrick; Goossens, Alain; Polyzos, Nikolaos P.; Tournaye, Herman

doi:10.1093/humrep/dev139

Cited by 104 publications

(84 citation statements)

References 25 publications

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“…Genetic causes of azoospermia include chromosomal abnormalities, Y chromosome microdeletions and specific mutations/deletions of several Y chromosomal genes (Miyamoto, Minase, Okabe, Ueda, & Sengoku, 2015). Approximately 10% of all male infertility cases (<1% of all men) are associated with non-obstructive azoospermia (Anniballo et al, 2000;Jarow, Espeland, & Lipshultz, 1989;Vloeberghs et al, 2015). This is a histopathological diagnosis based on testicular biopsy findings including hypospermatogenesis, maturation arrest [also called meiotic arrest (MA)] or Sertoli cell-only syndrome (SCOS).…”

Section: Introductionmentioning

confidence: 99%

Single-nucleotide polymorphisms in the human RAD21L gene may be a genetic risk factor for Japanese patients with azoospermia caused by meiotic arrest and Sertoli cell-only syndrome

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Single-nucleotide polymorphisms in the human RAD21L gene may be a genetic risk factor for Japanese patients with azoospermia caused by meiotic arrest and Sertoli cell-only syndrome

et al. 2017

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“…The median dosage of gonadotropins used was 1950 IU (interquartile range, 1650-2550 IU), duration of stimulation 12 days (11-14 days), peak oestradiol level 11 341 pmol/L (7859.5-19 260.5 pmol/L), and the number of metaphase II oocytes obtained was 8 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Pregnancy test was positive in 15/89 (16.9%) and the clinical pregnancy rate was 12/89 (13.5%).…”

Section: Resultsmentioning

confidence: 99%

“…17 With increasing awareness of male infertility, it is hoped that more men will seek professional help and share the burden in fertility treatment. Nevertheless, existing data available in the literature on outcomes of IVF-TESE are fragmentary 5 and local data are still lacking. Karyotypic abnormalities and Y-microdeletion have been associated with severe male factor infertility.…”

Section: Discussionmentioning

confidence: 99%

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Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia in Hong Kong

Chai

Lee

et al. 2016

Hong Kong Med J

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Objective: There are currently no local data on the sperm retrieval and pregnancy rates in in-vitro fertilisation and testicular sperm extraction cycles, especially with regard to the presence of genetic abnormalities. This study aimed to determine the sperm retrieval and pregnancy rates in infertile couples who underwent in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia.Methods: This retrospective case series was conducted at a tertiary assisted reproduction unit in Hong Kong. Men with non-obstructive azoospermia who underwent in-vitro fertilisation and testicular sperm extraction between January 2001 and December 2013 were included. The main outcome measures were sperm retrieval and pregnancy rates.Results: During the study period, 89 men with non-obstructive azoospermia underwent in-vitro fertilisation and testicular sperm extraction. Sperm was successfully retrieved in 40 (44.9%) men. There was no statistically significant difference in the sperm retrieval rate of those with karyotypic abnormalities (2/5, 40.0% vs 28/61, 45.9%; P=1.000) and AZFc microdeletion (3/6, 50.0% vs 28/61, 45.9%; P=1.000) compared with those without. Sperms were successfully retrieved in patients who had mosaic Klinefelter syndrome (2/3, 66.7%) but not in the patient with non-mosaic Klinefelter syndrome. No sperms were found in men with AZFa or AZFb microdeletions. Pregnancy test was positive in 15 (16.9%) patients and the clinical pregnancy rate was 13.5% (12/89) per cycle. The clinical pregnancy rate Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for nonobstructive azoospermia in Hong KongNew knowledge added by this study • Our study provides important local data for counselling of men with non-obstructive azoospermia. The sperm retrieval rate and clinical pregnancy rate per cycle in men undergoing in-vitro fertilisation and testicular sperm extraction in our unit were 44.9% and 13.5%, respectively.• There was no statistically significant difference in the sperm retrieval and pregnancy rates in those with karyotypic abnormalities and AZFc microdeletion compared with those without. Sperms, however, were not found in men with AZFa or AZFb microdeletions. Implications for clinical practice or policy • Although karyotype abnormalities and AZFc microdeletion did not affect the sperm retrieval and pregnancy rates in couples undergoing in-vitro fertilisation and testicular sperm extraction, karyotype and Y-microdeletion should be checked in men with non-obstructive azoospermia. The risk of vertical transmission of genetic abnormalities should be discussed and couples should be offered appropriate genetic counselling before treatment.

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“…In another study, spermatozoa were obtained with m-TESE in 36% of the patients with nonobstructive azoospermia. [9] Vloeberghs et al [10] found sperm retrieval, and pregnancy rates related to TESE procedure as 40.5, and 37%, respectively. They determined that 13.4% of all patients who had undergone TESE had delivered healthy babies.…”

Section: Discussionmentioning

confidence: 98%

Results of intracytoplasmic sperm injection performed with sperm retrieved by microscopic testicular sperm extraction in azoospermic patients

Erdem¹,

Karacan²,

Cebi³

et al. 2018

Turkish Journal of Urology

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Objective: The absence of any sperm in the ejaculate is called azoospermia and it is detected in 1% of males and 10-15% of those with infertility complaints. Azoospermia may be due to obstructive (OA) and non-obstructive (NOA) causes. Today, healthy pregnancies can be achieved in azoospermic patients by intracytoplasmic sperm injection (ICSI) performed using sperm retrieved from microscopic testicular sperm extraction (m-TESE). In this study, we examined the sperm retrieval rates with m-TESE in azoospermic patients, the results of ICSI in OA and NOA patients with sperm and the underlying testicular pathologies in patients without sperm. Material and methods:Patients who underwent m-TESE at IVF unit of our hospital between January 2005 and April 2017 were retrospectively reviewed. A total of 342 azoospermic patients (117 OA and 225 NOA cases) with regular follow-up were included in the study. In these cases, sperm retrieval and clinical pregnancy rates after ICSI were compared.Results: Mean duration of infertility was 28.2±7.8 months in the OA group, 34.2±5.4 years in patients, 30.3±2.9 years in spouses. In the NOA group, the mean duration of infertility was 30.3±6.5 months, the mean age of the patients was 35.3±3.4, and the mean age of the spouses was 30.6±3.3 years. In 68.9% of the cases, the therapeutic indication was male factor alone, while 31.1% had female factor infertility. In the OA group, 68.9% of the cases had only male factor infertility, while 31.1% of them had also female factor infertility. In the NOA group, 65.4% of the cases had only male factor infertility, and female factor was found in 34.6% of the cases. OA patients had a mean serum FSH level of 11.7±3.7 mIU/mL and mean testicular volume of 12.5±2.6 mL, NOA patients had a mean serum FSH level of 13.7±5.4 mIU/mL and mean testicular volume of 9.8±3.4 mL. In the m-TESE procedure, motile sperm was found in all of the OA patients and in 52.4% (118/225) of the NOA patients. Clinical pregnancy rate in the OA group was 29.9% (35/117) and live birth rate was 25.6% (30/117). In the NOA group, the clinical pregnancy rate was 27.1% (32/118) and the live birth rate was 23.7% (27/118). Histopathologic evaluation was made in 107 cases in the NOA group with no testicular sperm, revealing that 59 cases with germ-cell aplasia (sertoli-cell only syndrome), 42 cases with maturation arrest, and 6 cases with hypospermatogenesis. Postoperative hematoma developed in 3 of m-TESE cases and subsided with conservative treatment. Conclusion:If motile sperm is retrieved with m-TESE application in azoospermic patients, pregnancy resulting in one live birth in about 4 couples who undergo ICSI application can be achieved. In the presence of motile sperm, live birth rates are similar between OA and NOA case with very low complication rates.

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How successful is TESE-ICSI in couples with non-obstructive azoospermia?

Abstract: None declared.

Cited by 104 publications

References 25 publications

Single-nucleotide polymorphisms in the human RAD21L gene may be a genetic risk factor for Japanese patients with azoospermia caused by meiotic arrest and Sertoli cell-only syndrome

Single-nucleotide polymorphisms in the human RAD21L gene may be a genetic risk factor for Japanese patients with azoospermia caused by meiotic arrest and Sertoli cell-only syndrome

Sperm retrieval rate and pregnancy rate in infertile couples undergoing in-vitro fertilisation and testicular sperm extraction for non-obstructive azoospermia in Hong Kong

Results of intracytoplasmic sperm injection performed with sperm retrieved by microscopic testicular sperm extraction in azoospermic patients

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