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Very severe oligozoospermia with AZFc microdeletion patients may affect intracytoplasmic sperm injection clinical
Huan Zhang1, Huanzhu Li2, Shujuan Ma1,3
1NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences Central South University Changsha Hunan China.
Purpose:
To explore whether spermatozoa from AZFc microdeletion patients affect their outcomes of intracytoplasmic sperm injection (ICSI).
Methods:
Eighty-five patients with AZFc microdeletion were recruited. A control group of one hundred and forty patients with severe oligozoospermia but without AZF microdeletion was selected using propensity score matching analysis with a 1:2 nearest neighbor algorithm ratio. The ICSI outcomes of the two groups were compared.
Results:
AZFc microdeletion had lower rates of normal fertilization (73% vs. 80%, p = 0.17) and high-quality embryos (44% vs. 58%, p = 0.07) than the control group. There was no significant difference in the clinical pregnancy rate, miscarriage rate, and live birth rate between the two groups. When the sperm concentration was <1 million/mL, the AZFc microdeletion group exhibited lower rates of fertilization (71% vs. 80%, p = 0.03), high-quality embryo (44% vs. 58%, p = 0.02), clinical pregnancy (57% vs. 76%, p = 0.02), and live birth (49% vs. 72%, p = 0.01) than the control group. However, if sperm concentration was ≥1 million/mL, no significant differences were found.
Conclusion:
If the sperm concentration is <1 million/mL, AZFc microdeletion do have a detrimental effect on most outcomes of ICSI.
Insights
Spermatozoa from AZFc microdeletion patients can negatively impact intracytoplasmic sperm injection (ICSI) outcomes, particularly when sperm concentration is low. This finding is crucial for male infertility treatment strategies.
Area of Science:
- Reproductive Medicine
- Human Genetics
- Infertility Research
Background:
- AZFc microdeletions are a common cause of male infertility, affecting sperm production.
- Intracytoplasmic sperm injection (ICSI) is a key assisted reproductive technology for severe male factor infertility.
- The impact of AZFc microdeletions on ICSI outcomes requires further clarification.
Purpose of the Study:
- To investigate the effect of spermatozoa from patients with AZFc microdeletions on intracytoplasmic sperm injection (ICSI) success rates.
- To compare ICSI outcomes between patients with and without AZFc microdeletions.
Main Methods:
- A cohort of 85 patients with AZFc microdeletions was compared to 140 controls with severe oligozoospermia.
- Propensity score matching was used to create comparable groups.
- Key ICSI outcome measures, including fertilization, embryo quality, and pregnancy rates, were analyzed.
Main Results:
- While overall fertilization and high-quality embryo rates were slightly lower in the AZFc microdeletion group, clinical pregnancy and live birth rates did not differ significantly.
- In cases with sperm concentration below 1 million/mL, the AZFc microdeletion group showed significantly lower rates of fertilization, high-quality embryos, clinical pregnancy, and live birth.
- No significant differences in ICSI outcomes were observed when sperm concentration was 1 million/mL or higher.
Conclusions:
- AZFc microdeletions can have a detrimental effect on ICSI outcomes when sperm concentration is less than 1 million/mL.
- Sperm quality, specifically concentration, is a critical factor influencing the success of ICSI in patients with AZFc microdeletions.
- These findings highlight the importance of sperm concentration in predicting ICSI success for individuals with AZFc microdeletions.
