Age does not adversely affect sperm retrieval in men undergoing microdissection testicular sperm extraction

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility Research

Background:

• Male age is a potential factor influencing the success of assisted reproductive technologies.
• Microdissection testicular sperm extraction (micro-TESE) is a key procedure for sperm retrieval in nonobstructive azoospermia.

Purpose of the Study:

• To investigate the association between male age and the outcomes of micro-TESE.
• To evaluate the impact of male age on sperm retrieval rates (SRRs) and clinical pregnancy rates (CPRs).

Main Methods:

• A retrospective clinical study involving 1067 men with nonobstructive azoospermia.
• Micro-TESE was performed, followed by intracytoplasmic sperm injection (ICSI) if sperm were retrieved.
• Sperm retrieval and clinical pregnancy were the primary outcome measures.

Main Results:

• Overall SRR for micro-TESE was 56.6%, with higher rates in men aged ≥50 years (73%) compared to those <50 years (56%).
• Successful micro-TESE in older men was associated with larger testis volume and specific histological findings (hypospermatogenesis).
• Clinical pregnancy rates were lower for partners of men ≥50 years (25%) versus men <50 years (48%), partly due to older female partners.

Conclusions:

• Male age does not adversely affect sperm retrieval success rates in micro-TESE.
• While sperm can be retrieved from older men, optimal clinical pregnancy outcomes are associated with younger female partners (<35 years).
• The study suggests that some older men with azoospermia may have secondary forms of the condition, contributing to successful sperm retrieval.