Objective:To investigate the effect of treatment with orchiopexy at different ages on the clinical outcomes of nonobstructive azoospermia (NOA) patients with a history of cryptorchidism who underwent microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI).Methods:NOA patients undergoing microTESE combined with ICSI from December 2013 to August 2019 in the ICSI treatment cycle in Assisted Reproduction Center of Northwest Women and Children's Hospital were collected in this retrospective cohort study. According to the history of cryptorchidism, the patients were divided into cryptorchidism group and non-cryptorchidism group. The sperm retrieval rates (SRRs) were assessed between these two groups. Then, based on the timing of treatment with orchiopexy, the NOA patients with orchidopexy were subdivided into prepubertal group and pubertal-postpubertal group. The SRRs and the pregnancy outcomes were also assessed.Results:There were 34 NOA patients with cryptorchidism and 604 NOA patients without cryptorchidism underwent microTESE. The SRRs in NOA patients with or without cryptorchidism were 85.3% (29/34) and 40.2% (243/604), respectively. The differences were statistically significant ( P<0.001). In the prepubertal surgery group, sperm was detected in 17 cases, while in the pubertal-postpubertal surgery group, the sperm was detected in 12 cases. The differences were statistically significant ( P=0.044). The total clinical pregnancy rate of cryptorchidism NOA patients treated with ICSI was 65.4% (17/26). Among these individuals, the clinical pregnancy rate of the prepubertal group was 62.5% (10/16) and the pubertal-postpubertal group was 70.0% (7/10). There were no statistical differences in clinical pregnancy rate. Some other clinical pregnancy outcomes, including miscarriage rate in early pregnancy, the rate of cycle with 2PN and the rate of cycle with top-quality embryo, also showed no differences between the two groups. In pathology analysis, all the cryptorchidism NOA patients with failure sperm retrieval were Sertoli cell only syndrome (SCOS). The pubertal-postpubertal group had a significant higher morbidity of SCOS [76.5% (13/17)] compared with the prepubertal group [35.3% (6/17)] ( P=0.016). In addition, the volume of testis, the level of follicle-stimulating hormone and testosterone were not statistically associated with SRR. Conclusion:The SRR of NOA patients with cryptorchidism was higher than those without cryptorchidism. The age at orchidopexy operation may have little effect on the pregnancy outcome of ICSI. It may be more beneficial for microTESE to obtain sperm by undergoing orchiopexy as early as possible.

Objective:To investigate the effect of treatment with orchiopexy at different ages on the clinical outcomes of nonobstructive azoospermia (NOA) patients with a history of cryptorchidism who underwent microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI).Methods:NOA patients undergoing microTESE combined with ICSI from December 2013 to August 2019 in the ICSI treatment cycle in Assisted Reproduction Center of Northwest Women and Children's Hospital were collected in this retrospective cohort study. According to the history of cryptorchidism, the patients were divided into cryptorchidism group and non-cryptorchidism group. The sperm retrieval rates (SRRs) were assessed between these two groups. Then, based on the timing of treatment with orchiopexy, the NOA patients with orchidopexy were subdivided into prepubertal group and pubertal-postpubertal group. The SRRs and the pregnancy outcomes were also assessed.Results:There were 34 NOA patients with cryptorchidism and 604 NOA patients without cryptorchidism underwent microTESE. The SRRs in NOA patients with or without cryptorchidism were 85.3% (29/34) and 40.2% (243/604), respectively. The differences were statistically significant ( P<0.001). In the prepubertal surgery group, sperm was detected in 17 cases, while in the pubertal-postpubertal surgery group, the sperm was detected in 12 cases. The differences were statistically significant ( P=0.044). The total clinical pregnancy rate of cryptorchidism NOA patients treated with ICSI was 65.4% (17/26). Among these individuals, the clinical pregnancy rate of the prepubertal group was 62.5% (10/16) and the pubertal-postpubertal group was 70.0% (7/10). There were no statistical differences in clinical pregnancy rate. Some other clinical pregnancy outcomes, including miscarriage rate in early pregnancy, the rate of cycle with 2PN and the rate of cycle with top-quality embryo, also showed no differences between the two groups. In pathology analysis, all the cryptorchidism NOA patients with failure sperm retrieval were Sertoli cell only syndrome (SCOS). The pubertal-postpubertal group had a significant higher morbidity of SCOS [76.5% (13/17)] compared with the prepubertal group [35.3% (6/17)] ( P=0.016). In addition, the volume of testis, the level of follicle-stimulating hormone and testosterone were not statistically associated with SRR. Conclusion:The SRR of NOA patients with cryptorchidism was higher than those without cryptorchidism. The age at orchidopexy operation may have little effect on the pregnancy outcome of ICSI. It may be more beneficial for microTESE to obtain sperm by undergoing orchiopexy as early as possible.

Objective: To analyze the ratio of pulmonary valve ring to aortic valve ring (GA ratio), and to explore the application value of GA ratio in predicting the need of transannular patch in the radical operation of children with tetralogy of Fallot (TOF). Methods: A retrospective analysis was performed in 355 children (182 males and 173 females) with TOF and underwent radical operation in the Pediatric Cardiac Center of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2017.They were divided into transannular patch group and non-transannular patch group.The values of pulmonary valve ring and aortic valve ring in two groups were collected, and the Z-score of pulmonary artery and GA ratio were calculated respectively for statistical analysis. Results: Among the 355 patients, 156 children (43.9%) required a transannular patch, and 199 patients (56.1%) did not receive transannular patch.The GA ratio and the Z-score of of pulmonary artery in the transannular patch group were lower than those in the non-transannular patch group [0.45±0.12 vs. 0.54±0.15, (-1.75±0.98) scores vs.(-0.86±1.39) scores], and the differences were statistically significant (t=5.29, 6.32, all P<0.01). Receiver operating characteristic curve analysis showed that in the case of the Z-score of pulmonary artery of -2 for the children received transannular patch, the area under the curve (AUC) was 0.702 (95%CI: 0.64-0.76), sensitivity was 69%, and specificity was 83%; in the case of the GA ratio of 0.58 for the children received transannular patch, the AUC was 0.712 (95%CI: 0.66-0.77), sensitivity was 70%, and specificity was 87%. Conclusions The GA ratio is a simple and effective predictor of transannular patch in the radical operation of TOF and can be applied in clinical practice.

Objective:To investigate the clinical outcome of microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoospermia (NOA) associated with mumps orchitis.Methods:The clinical data of NOA patients who underwent microTESE from December 2013 to October 2019 in the ICSI treatment cycle in Assisted Reproduction Center, Northwest Women and Children's Hospital were collected. All the patients who had a history of mumps were divided into two groups according to whether they had mumps orchitis or not. The clinical outcomes after the implementation of microTESE combined with ICSI were compared.Results:A total of 52 NOA patients were finally collected in the present study and 26 patients successfully processed sperm retrieval, the total sperm retrieval rate (SRR) was 50.0% (26/52). The SRR was 94.4% (17/18) in ornitis group, and 26.5% (9/34) in non-ornitis group. The difference between the two groups was statistically significant ( P<0.001). ICSI treatment was tried in sperm patients, and the clinical pregnancy rate was 61.5% (16/26). There was no statistically significant difference in the clinical pregnancy rate and the early pregnancy abortion rate between ornitis group and non-ornitis group [58.5% (10/17) vs. 66.7% (6/9), P=0.696; 20.0% (2/10) vs. 16.7% (1/6), P=0.868]. In the laboratory data, the difference of two pronucleus rate between orchitis group and non-orchitis group was statistically significant (73.9% vs. 57.0%, P=0.006), while the difference of high-quality embryo rate between the two groups was not statistically significant (44.2% vs. 56.8%, P=0.144). Conclusion:The SRR of NOA patients with mumps orchitis was higher that of out ornitis. And good results can be expected when microTESE and ICSI treatment are performed at the same period.

Objective:To investigate the clinical outcome of microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoospermia (NOA) associated with mumps orchitis.Methods:The clinical data of NOA patients who underwent microTESE from December 2013 to October 2019 in the ICSI treatment cycle in Assisted Reproduction Center, Northwest Women and Children's Hospital were collected. All the patients who had a history of mumps were divided into two groups according to whether they had mumps orchitis or not. The clinical outcomes after the implementation of microTESE combined with ICSI were compared.Results:A total of 52 NOA patients were finally collected in the present study and 26 patients successfully processed sperm retrieval, the total sperm retrieval rate (SRR) was 50.0% (26/52). The SRR was 94.4% (17/18) in ornitis group, and 26.5% (9/34) in non-ornitis group. The difference between the two groups was statistically significant ( P<0.001). ICSI treatment was tried in sperm patients, and the clinical pregnancy rate was 61.5% (16/26). There was no statistically significant difference in the clinical pregnancy rate and the early pregnancy abortion rate between ornitis group and non-ornitis group [58.5% (10/17) vs. 66.7% (6/9), P=0.696; 20.0% (2/10) vs. 16.7% (1/6), P=0.868]. In the laboratory data, the difference of two pronucleus rate between orchitis group and non-orchitis group was statistically significant (73.9% vs. 57.0%, P=0.006), while the difference of high-quality embryo rate between the two groups was not statistically significant (44.2% vs. 56.8%, P=0.144). Conclusion:The SRR of NOA patients with mumps orchitis was higher that of out ornitis. And good results can be expected when microTESE and ICSI treatment are performed at the same period.