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Poor intracytoplasmic sperm injection outcome in infertile males with azoospermia factor c microdeletions
Li Zhang1, Jia-Ming Mao1, Ming Li1
1Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Beijing, People's Republic of China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, People's Republic of China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, People's Republic of China.
Objective:
To explore whether the presence of azoospermia factor c (AZFc) microdeletions adversely affects intracytoplasmic sperm injection (ICSI) outcome.
Design:
Retrospective cohort.
Setting:
University hospital.
Patient(S):
A total of 293 patients with azoospermia or severe oligozoospermia AZFc deletions underwent 345 ICSI cycles, and 363 idiopathic patients with normal Y chromosome underwent 462 ICSI cycles.
Intervention(S):
Testicular sperm aspiration, microdissection testicular sperm extraction.
Main Outcome Measure(S):
The main clinical outcome parameters were cumulative clinical pregnancy rate, cumulative live birth delivery rate, and no embryo suitable for transfer cycle rate.
Result(S):
Compared with the control group, the AZFc deletion group exhibited poorer ICSI outcome, with significant differences between the 2 groups for cumulative clinical pregnancy rate (45.39% vs. 67.49%; odds ratio [OR], 2.843; 95% confidence interval [CI]), cumulative live birth delivery rate (35.15% vs. 53.44%; OR, 2.234; 95% CI), no embryo suitable for transfer cycle rate (15.07% vs. 8.23%; OR, 0.565; 95% CI), fertilization rate (46.80% vs. 53.37%; adjusted β, -0.074; 95% CI), implantation rate (28.63% vs. 31.26%; adjusted β, -0.075; 95% CI) separately. The poor ICSI outcome of the AZFc deletion group was related to AZFc microdeletions by linear and logistic regression analyses.
Conclusion(S):
AZFc microdeletions adversely affect ICSI outcome; patients with AZFc deletion should be informed that they have reduced opportunities to be biological fathers.
Insights
Azoospermia factor c (AZFc) microdeletions significantly reduce intracytoplasmic sperm injection (ICSI) success rates. Patients with AZFc deletions face lower chances of achieving pregnancy and live births, impacting biological fatherhood.
Area of Science:
- Reproductive Medicine
- Human Genetics
- Infertility Research
Background:
- Azoospermia factor c (AZFc) microdeletions are a common genetic cause of male infertility.
- The impact of AZFc microdeletions on intracytoplasmic sperm injection (ICSI) outcomes remains an area of active investigation.
Purpose of the Study:
- To investigate the association between AZFc microdeletions and the success rates of ICSI procedures.
- To determine if AZFc deletions adversely affect key ICSI outcome parameters.
Main Methods:
- A retrospective cohort study was conducted at a university hospital.
- Compared ICSI outcomes in 293 patients with AZFc deletions against 363 idiopathic patients with normal Y chromosomes.
- Analyzed cumulative clinical pregnancy rates, live birth delivery rates, and embryo transfer suitability.
Main Results:
- Patients with AZFc deletions showed significantly lower cumulative clinical pregnancy rates (45.39% vs. 67.49%) and live birth delivery rates (35.15% vs. 53.44%) compared to controls.
- The AZFc deletion group had a higher rate of no suitable embryos for transfer (15.07% vs. 8.23%) and lower fertilization and implantation rates.
- Linear and logistic regression analyses confirmed that AZFc microdeletions are linked to poorer ICSI outcomes.
Conclusions:
- AZFc microdeletions are associated with adverse effects on ICSI outcomes, including reduced pregnancy and live birth rates.
- Patients diagnosed with AZFc deletions should be counseled about their diminished prospects for biological fatherhood through ICSI.
- Further research may explore tailored ICSI protocols for patients with AZFc deletions.
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