Do assisted reproduction outcomes differ according to aetiology of obstructive azoospermia?

Abstract

Azoospermia is defined as absence of spermatozoa and may be secondary to blocked seminal ducts, known as obstructive azoospermia. Semen quality may be impaired due to factors such as sperm cell DNA fragmentation and presence of antisperm antibodies. The objective of this article was to investigate potential differences in outcomes of in vitro fertilisation and intracytoplasmic sperm injection between groups with different obstruction aetiology, as well as between the use of different techniques and sperm cells of different origins. Retrospective, multi‐centre analysis of 621 first cycles was carried out between 2008 and 2015: Group I, congenital obstruction, 45 patients and Group 2, vasectomy, 576 patients. Sperm cell retrieval was achieved in all cases. Results were similar for Group I and II fertilisation rates, 70% versus 66.85% (p = .786); pregnancy rates, 42.5% versus 41.46% (p = .896); and live birth rates, 29.73% versus 17.69% (p = .071). According to sperm cell origin (579 epididymal vs. 42 testicular), pregnancy rates, 41.47% versus 43.9% (p = .760); and live birth rates, 18.3% versus 27.78% (p = .163) had no difference. Fertilisation, pregnancy and live birth rates did not differ according to obstruction aetiology. Outcomes did not differ between groups according to sperm cell origin.

Pathogenesis of Autoimmune Male Infertility: Juxtacrine, Paracrine and Endocrine Deregulation

“…As already noted, ASAs are often found in infertile men with varicocele [7,41,59,81]. Immunological infertility was registered in 15-28% of men with varicocele [78,80,108,112]. In addition, B.R.…”

“…It has been noticed that the quality of sperm deteriorates significantly in the presence of ASAs [80]. The effect of ASAs on reproductive function can be realized in various ways: impaired spermatogenesis, sperm agglutination, decreased motility, impaired penetration of spermatozoa into cervical mucus, impaired acrosomal reaction, obstruction of ovum fertilization, impaired embryo implantation and deranged early development of zygote [2,29,32,39,55,70,78,[81][82][83][84][85].…”

“…Varicocele is traditionally considered a potentially curable cause of male infertility, and varicocelectomy still serves as the gold standard of treatment; however, surgical intervention often fails to restore fertility, improve semen analysis, so the outcome of the operation remains poorly predictable [24,51,76]. Earlier ASAs were not considered as a factor that negatively affects the result of surgical treatment, but nowadays many researchers reported ASAs level increase after surgical intervention [42,43,50,78,80,86,117,[120][121][122].…”

Pathogenesis of Autoimmune Male Infertility: Juxtacrine, Paracrine, and Endocrine Dysregulation

“…It has been noticed that the quality of sperm deteriorates significantly in the presence of ASAs [ 80 ]. The effect of ASAs on reproductive function can be realized in various ways: impaired spermatogenesis, sperm agglutination, decreased motility, impaired penetration of spermatozoa into cervical mucus, impaired acrosomal reaction, obstruction of ovum fertilization, impaired embryo implantation, and deranged early development of zygote [ 2 , 29 , 32 , 39 , 55 , 70 , 78 , 81 , 82 , 83 , 84 , 85 ].…”

Tissue and sperm handling before assisted reproductive technology (ART): A systematic review

“…The SRR is calculated by dividing the number of successful cases by the number of total cases performed. In OA, the SRR is near 100%, the ICSI outcomes do not differ if testicular or epididymal sperm is used [ 54 ].…”