Non-obstructive azoospermia: Micro-TESE combined with advanced sperm processing for enhanced assisted reproductive...

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility Research

Background:

• Non-obstructive azoospermia (NOA) affects 10% of male infertility cases.
• Microdissection testicular sperm extraction (mTESE) is the gold standard for sperm retrieval in NOA.
• Optimizing assisted reproductive technology (ART) pathways is crucial for live birth outcomes.

Purpose of the Study:

• To evaluate live birth and ongoing pregnancy rates (LBR) following mTESE in NOA patients.
• To assess the impact of advanced sperm preparation techniques on ART outcomes.
• To identify risk factors associated with unsuccessful sperm retrieval in NOA.

Main Methods:

• Retrospective study of 55 NOA patients undergoing mTESE (July 2019 - March 2023).
• Primary outcome: LBR; Secondary outcome: Sperm Retrieval Rate (SRR).
• Univariate analyses to identify risk factors for unsuccessful sperm retrieval.

Main Results:

• SRR was 47.3% (53.2% excluding Klinefelter patients).
• LBR and ongoing pregnancies achieved in 27.3% of couples.
• Karyotype abnormalities, elevated FSH, and familial infertility correlated with unsuccessful sperm retrieval.

Conclusions:

• mTESE combined with advanced techniques resulted in a 27.3% LBR/ongoing pregnancy rate in NOA.
• Successful sperm retrieval and subsequent live birth are achievable without donor sperm.
• Identifying risk factors can help counsel patients undergoing mTESE for NOA.