Analysis of clinical outcome of asynchronous micro-TESE and ICSI in patients with non-obstructive aoospermia caused by AZFc deletion
10.3760/cma.j.cn101441-20220323-00128
- VernacularTitle:AZFc缺失非梗阻性无精子症患者非同步micro-TESE后ICSI临床结局分析
- Author:
Jiaming MAO
1
;
Defeng LIU
;
Lianming ZHAO
;
Haocheng LIN
;
Zhe ZHANG
;
Yuzhuo YANG
;
Haitao ZHANG
;
Kai HONG
;
Rong LI
;
Hui JIANG
Author Information
1. 北京大学第三医院生殖医学中心，北京 100191
- Publication Type:Journal Article
- Keywords:
Sperm injection, intracytoplasmic;
AZFc deletion;
Non-obstructive azoospermia;
Micro-dissection testicular sperm extraction;
Clinical outcome
- From:
Chinese Journal of Reproduction and Contraception
2023;43(9):944-948
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the therapeutic effect of micro-dissection testicular extraction (micro-TESE) combined with intracytoplasmic sperm injection (ICSI) technology, and guide the clinical treatment of non-obstructive azoospermia (NOA) with azoospermia factor (AZF) c-region deletion.Methods:Through retrospective study, the clinical data of NOA patients with AZFc deletion were analyzed who underwent asynchronous micro-TESE in Reproductive Medicine Centre of Peking University Third Hospital from January 2015 to December 2019. The clinical outcomes of ICSI in patients who successfully obtained sperm were followed up, including fertilization rate, good-quality embryo rate, clinical pregnancy rate, abortion rate and live birth rate.Results:A total of 47 patients with NOA caused by AZFc deletion underwent asynchronous micro-TESE and 28 cases successfully found spermatozoa during the operation. The sperm retrieval rate (SRR) was 59.6% (28/47). Totally 25 cases cryopreserved testicular spermatozoa and 15 cases underwent thawed-sperm ICSI and 14 of them found enough spermatozoa for ICSI. Among the 28 patients who successfully found sperm during the first micro-TESE operation, 14 gave up the use of sperm and another 14 later used the thawed sperm for ICSI. A total of 14 cryopreserved sperm ICSI cycles were carried out, followed by 11 embryo transfer cycles. Only one patient successfully gave birth to one health boy. After that 11 patients underwent the second synchronous micro-TESE and spermatozoa were all successfully found during the operation. Eleven cycles used fresh sperm for ICSI followed by 11 embryo transfer cycles. Finally, 3 patients successfully gave birth to 1 boy and 2 girls.Conclusion:Patients of NOA caused by AZFc deletion have a high probability of successfully obtaining spermatozoa in testis through micro-TESE for ICSI to breed offspring with their own biological characteristics. For patients failed in the first asynchronous procedure, the second synchronous micro-TESE with fresh spermatozoa for ICSI can be considered to improve the utilization rate of sperm and the final live birth rate.
