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Published on: May 27, 2022
Sperm retrieval rate and patient factors in azoospermia factor c microdeletion azoospermia: a systematic review
Zhong-Yu Jiao1,2, Mao-Ran Li1,2, Lin Zhuo3
1Department of Urology, Peking University Third Hospital, Beijing, China.
Objective:
To reveal the overall sperm retrieval rate (SRR) and range in patients with azoospermia factor c (AZFc) microdeletion azoospermia by microdissection testicular sperm extraction (mTESE) and discuss the differences of preoperative patient factors among studies with various SRRs.
Patients And Methods:
We searched PubMed, Web of Science and Embase until February 2023. All studies reporting SRRs by mTESE and required parameters of patients with AZFc microdeletions were included. The primary outcome was the SRR and, if available, the pregnancy rate (PR) and live-birth rate (LBR) after intracytoplasmic sperm injection were also investigated as secondary outcomes.
Results:
Eventually 11 cohort studies were included in this review. A total number of 441 patients underwent mTESE and in 275 of them sperm was obtained, reaching an overall SRR of 62.4%. The SRRs among studies had a wide range from 25.0% to 85.7%. The studies reporting higher SRRs generally had older mean ages, and higher follicle-stimulating hormone and testosterone levels. Only four studies provided practical data on pregnancies and live-born children of patients with AZFc microdeletions, so the overall PR and LBR were unavailable.
Conclusions:
The overall SRR of patients with AZFc microdeletion azoospermia was 62.4%. The effect of patient factors in SR needs further evidence in future work.
Insights
Microdissection testicular sperm extraction (mTESE) achieved a 62.4% sperm retrieval rate (SRR) in men with AZFc microdeletion azoospermia. Higher SRRs were linked to older patient age and elevated hormone levels, though more research is needed.
Area of Science:
- Reproductive Medicine
- Genetics
- Urology
Background:
- Azoospermia factor c (AZFc) microdeletions are a significant cause of male infertility.
- Microdissection testicular sperm extraction (mTESE) is a key surgical technique for sperm retrieval in such cases.
Purpose of the Study:
- To determine the overall sperm retrieval rate (SRR) for mTESE in patients with AZFc microdeletion azoospermia.
- To analyze the range of SRRs across different studies.
- To explore correlations between preoperative patient factors and SRR.
Main Methods:
- A systematic review and meta-analysis of studies published until February 2023.
- Inclusion criteria: studies reporting SRRs for mTESE in patients with AZFc microdeletions.
- Data extraction included SRR, patient demographics, and hormonal levels.
Main Results:
- Eleven cohort studies comprising 441 patients were analyzed.
- The overall SRR was 62.4% (275/441 patients).
- Reported SRRs varied widely (25.0% to 85.7%); higher rates correlated with older mean age and elevated FSH and testosterone levels.
Conclusions:
- mTESE offers a 62.4% SRR for azoospermia caused by AZFc microdeletions.
- Patient factors like age and hormone levels may influence SRR, but require further investigation.
- Limited data precluded analysis of pregnancy and live-birth rates.
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