Clinical outcomes of microdissection testicular sperm extraction and intracytoplasmic sperm injection in Japanese men with Y chromosome microdeletions

Abstract

Purpose We investigated the clinical results of Japanese men with Y chromosome microdeletions. Methods This study retrospectively examined 2163 azoospermic or severe oligozoospermic patients. We investigated the frequency of azoospermia factor (AZF) deletions and sperm retrieval rate (SRR) by microTESE in patients with these deletions, then analyzed the ICSI outcomes. Results Azoospermia factor deletions were found in 201 patients. SRR was significantly higher than that of the control group (74.0% vs 20.4%, P < .001). Thirty‐three couples underwent ICSI using testicular spermatozoa retrieved by microTESE, and eight couples underwent ICSI using ejaculatory spermatozoa. The fertilization rate and clinical pregnancy rate per embryo transfer cycle were significantly higher in the ejaculatory group than that of the testicular group (66.4% vs 43.7%, P < .001, 53.3% vs 24.7%, P = .03, respectively). When compared with the control group, the fertilization rate was significantly lower in the testicular group with AZFc microdeletions (43.7% vs 53.6%, P < .001). Conclusions Our study highlights that although microTESE in azoospermic men with AZFc microdeletions led to a higher SRR, ICSI outcomes of these men were worse than that of men without AZF deletions, even if testicular spermatozoa were retrieved.

A systemic review and meta‐analysis exploring the predictors of sperm retrieval in patients with non‐obstructive azoospermia and chromosomal abnormalities

“…The AZFc microdeletion group exhibited the highest positive SSR outcome with 41.95%, while the KS group had a success rate of 38.63%. The higher SSR in AZFc microdeletion patients is consistent with previous studies and may be due to the varying histopathology patterns attributed to this microdeletion as well as a number of foci for spermatogenesis within the testis (Hopps et al, 2003;Sabbaghian et al, 2018;Yamaguchi et al, 2020).…”

“…Quality assessment of the included studies revealed the majority of studies (n = 37; 69.81%) to be of fair quality scoring a total of 6 stars, while the remaining 16 (30.19%) studies were considered of high quality (8 studies scoring 9 stars (Bakircioglu et al, 2011;Chehrazi et al, 2017;Choi et al, 2013;Ishikawa et al, 2009;Plotton et al, 2015;Tsujimura et al, 2004;Yamaguchi et al, 2020;Zhang et al, 2021) and 8 studies scoring 7 stars (Arafa et al, 2018;Chen et al, 2019;Huang et al, 2020;Iwatsuki et al, 2017;Klami et al, 2018;Kleiman et al, 2016;Ko et al, 2016;Takeda et al, 2017).…”

Poor intracytoplasmic sperm injection outcome in infertile males with azoospermia factor c microdeletions

“…As a result, patients with azoospermic AZFc deletion can undergo ICSI with either testicular or ejaculated sperm with the help of assisted reproductive technology (ART). Some studies (2,(9)(10)(11)(12)(13) have reported that AZFc microdeletions do not affect the clinical outcome because patients with both azoospermia and severe oligozoospermia AZFc deletions exhibited similar outcomes with that of patients with a normal Y chromosome. It has been reported recently (14) that patients with AZFc deletion showed unsatisfactory outcomes compared with patients with other nonobstructive azoospermia (NOA) in a small sample size (n ¼ 91), but they did not investigate the reason for this poor outcome.…”

Preimplantation Genetic Testing for Aneuploidies Improve the Clinical Pregnancy Outcome of Patients With AZFc Microdeletion

“…Compared to ICSI using microTESE and ejaculatory sperm, the outcome of later sperm performed better [13,14,22]. In this study, our results show that PGT-A can signi cantly improve clinical outcomes after ICSI with ejaculated sperm in AZFc patients.…”