Factors predicting the outcome of percutaneous epididymal sperm aspiration in men with obstructive azoospermia.

Autor: Almekaty KM; Tanta University Hospital, Urology Department, Tanta. dr.khaledhafez@med.tanta.edu.eg., Zahran MH; Mansoura Urology-Nephrology Centre, Urology Department, Mansoura. zahranmha@yahoo.com., Lotfy Amer M; Tanta University Hospital, Urology Department, Tanta. drmlamer@med.tanta.edu.eg., Hagras AM; Tanta University Hospital, Urology Department, Tanta. ahagras80@yahoo.com., Salem KA; Tanta University Hospital, Urology Department, Tanta. khsalemmd@gmail.com., Rashed AS; October 6 University, Faculty of Medicine, Department of Urology, Cairo. aymanrashed@msn.com., Ghaith AF; Tanta University Hospital, Urology Department, Tanta. dr_ahmedfayez@yahoo.com.
Jazyk: angličtina
Zdroj: Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica [Arch Ital Urol Androl] 2022 Sep 26; Vol. 94 (3), pp. 323-327. Date of Electronic Publication: 2022 Sep 26.
DOI: 10.4081/aiua.2022.3.323
Abstrakt: Objectives: To report on the live birth rates (LBRs) following percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia (OA) and factors affecting treatment outcome which is under reported in the literature.
Methods: This is a multicenter study that was conducted in Egypt including all couples undergoing intra cytoplasmic sperm injection (ICSI) for OA using PESA-derived sperms. Men were subdivided according to aetiology into congenital, iatrogenic and idiopathic groups. Fertilization, pregnancy and LBRs were determined and compared in each group. The longitudinal LBR, crude and expected cumulative delivery rates (CCDR, ECDR) were calculated. Multiple logistic regression analysis was used to determine significant associations between maternal, paternal and ICSI factors with successful live births.
Results: Ninety couples were included in the study. Viable sperm for ICSI was retrieved in 89 men (98.9%). A total of 155 ICSI cycles with 17 frozen embryo transfers resulted in 81 pregnan-cies and 55 live births. After 5 cycles, the longitudinal LBR, CCDR and ECDR were 30%, 57.3% and 88.6% respectively. Maternal age and number of fertilized eggs were the only fac-tors significantly affecting LBRs.
Conclusions: PESA is a minimally invasive procedure for secur-ing viable sperm for ICSI in OA men, with high cumulative delivery rates. Maternal age and number of fertilized eggs are the only factors that significantly affecting LBR. The contempo-rary longitudinal and cumulative LBRs provide objective out-come data to counsel OA patients undergoing fertility treat-ments.
Databáze: MEDLINE
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