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Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia

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

V Vloeberghs¹, G Verheyen², P Haentjens³

¹Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium veerle.vloeberghs@uzbrussel.be.

Human Reproduction (Oxford, England)

|June 18, 2015

Summary

For couples with infertility due to non-obstructive azoospermia (NOA), testicular sperm extraction with ICSI (TESE-ICSI) offers a chance for biological fatherhood. However, only a minority of men (13.4%) successfully father a child through this method.

Keywords:

ICSI TESE cumulative delivery rate non-obstructive azoospermia pregnancy

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Area of Science:

Reproductive Medicine
Andrology
Infertility Treatment

Background:

Limited data exist on the overall success rates of testicular sperm extraction with ICSI (TESE-ICSI) for couples with non-obstructive azoospermia (NOA).
Previous studies often report sperm retrieval or ICSI outcomes separately, not the cumulative chance of fatherhood.

Purpose of the Study:

To determine the cumulative live birth delivery rate for couples with NOA undergoing TESE-ICSI.
To provide reliable data for counselling men with NOA regarding their chances of fathering a genetically own child.

Main Methods:

Retrospective cohort study of 714 men with NOA undergoing their first testicular biopsy between 1994 and 2009.
Longitudinal follow-up of couples through consecutive ICSI cycles using testicular sperm (fresh and/or frozen).
Primary outcome: live birth delivery; Secondary outcomes: sperm retrieval and pregnancy rates.

Main Results:

Successful sperm retrieval occurred in 40.5% of men during their first TESE.
A total of 96 live birth deliveries resulted from 261 couples undergoing 444 ICSI and 48 frozen embryo transfer cycles.
The crude cumulative live birth delivery rate after six ICSI cycles was 37%.

Conclusions:

TESE-ICSI is a significant advancement for NOA infertility, achieving a 37% delivery rate among couples undergoing ICSI.
Unselected men with NOA should be informed that only 13.4% eventually become biological fathers after TESE.
The study highlights the need for careful counselling regarding the overall probability of fatherhood.