[Sperm donation utilization rates in nonobstructive azoospermia patients under different testicular sperm retrieval...

To analyze the proportion of nonobstructive azoospermia (NOA) patients opting for sperm bank donation under different sperm retrieval methods [percutaneous testicular sperm aspiration (TESA), microdissection testicular sperm extraction (mTESE)] and its influencing factors.

Retrospective data from assisted reproductive technology (ART) cycles at the Center for Reproductive Medical, Peking University Third Hospital (from January 2019 to December 2023) were collected. Data-complete ART cycles involving NOA patients and their partners (using the last treatment cycle as the endpoint) were selected. Sperm donation utilization rates were compared across retrieval methods (fresh mTESE, fresh TESA, thawed mTESE, thawed TESA). Log-linear models were used to analyze the relationship between sperm retrieval method and sperm source.

Among the 1 730 couples, the overall sperm donation utilization rate was 12.66%. The highest rate occurred in the fresh mTESE group (23.42%), followed by the thawed mTESE group (5.87%). The rates for the fresh TESA and thawed TESA groups were 5.22% and 0%, respectively. Log-linear analysis demonstrated that sperm retrieval method was significantly associated with sperm source (mTESE: Estimate=4.499; TESA: Estimate=2.780; P < 0.001).

The low overall sperm donation utilization rate in ART cycles may reflect the efficacy of synchronous sperm retrieval ART. The proportion of NOA patients opting for sperm donation was influenced by the retrieval method. Compared with patients undergoing TESA, those undergoing mTESE were more inclined to utilize donor sperm after retrieval failure.