Xiaochen Yu1,2,3,4, Shaoming Lu1,2,3,4, Mingzhen Yuan1,2,3,4, Gang Ma1,2,3,4, Xiao Li1,2,3,4, Taijian Zhang1,2,3,4, Shanshan Gao1,2,3,4, Daimin Wei1,2,3,4, Zi-Jiang Chen1,2,3,4,5, Hongbin Liu6,7,8,9, Haobo Zhang10,11,12,13,14. 1. Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China. 2. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China. 3. Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China. 4. Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China. 5. Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, 200135, China. 6. Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China. hongbin_sduivf@aliyun.com. 7. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China. hongbin_sduivf@aliyun.com. 8. Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China. hongbin_sduivf@aliyun.com. 9. Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China. hongbin_sduivf@aliyun.com. 10. Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong, China. zhanghaobo@sdu.edu.cn. 11. Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China. zhanghaobo@sdu.edu.cn. 12. Shandong Key Laboratory of Reproductive Medicine, Jinan, 250012, Shandong, China. zhanghaobo@sdu.edu.cn. 13. Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, 250012, Shandong, China. zhanghaobo@sdu.edu.cn. 14. The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China. zhanghaobo@sdu.edu.cn.
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.
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.
Authors: D Plaseska-Karanfilska; P Noveski; T Plaseski; I Maleva; S Madjunkova; Z Moneva Journal: Balkan J Med Genet Date: 2012-12 Impact factor: 0.519