Predictive factors for sperm retrieval and sperm injection outcomes in obstructive azoospermia: Do etiology, retrieval techniques and gamete source play a role?

Abstract

Obstructive azoospermia is a relatively common male infertility condition. The main etiologies of obstructive azoospermia include congenital, surgical-derived, traumatic and post-infectious cases. Although seminal tract reconstruction is a cost-effective treatment in most cases, this approach may not be feasible or desired in some cases. In such cases, assisted reproduction techniques offer a method for achieving pregnancy, notably via sperm retrieval and intracytoplasmic sperm injection. This process requires several considerations and decisions to be made, including the cause and duration of obstruction, which sperm retrieval technique to use, and whether to use fresh or frozen-thawed sperm. We present a review of obstructive azoospermia and assisted reproduction techniques, highlighting the most relevant aspects of the decision-making process for use in clinical practice.

Prospective Study of Predictive Factors and Outcome in Sperm Retrieval of Azoospermic Males: Initial Experience in Tertiary Care Centre

“…Miyaoka R et al in their article published in 2013 mention pregnancy rates between 31% to 43% after using surgically retrieved sperms for ICSI. (12) Dabaja et al in his study published in 2013 found pregnancy rate of 48% by using retrieved sperms (25) .…”

“…Once fertilized, the embryo is implanted into female uterus for development. (10,11) The sperm recovery rates ranges from 90% to 100% for obstructive azoospermia using any of standard surgical technique (12) , but the sperm recovery rates for non-obstructive azoospermia range from 30-63% for TESE, and 43-63% for Micro-TESE; the rate for TEFNA is approximately 47%. (17) Out of all patients of azoospermia approximately 36% are due to obstructive azoospermia.…”

“…(17) Out of all patients of azoospermia approximately 36% are due to obstructive azoospermia. (12) Thus on an average overall surgical success rate for sperm retrieval ranges between 50% to 70%. Thus in around 30% to 50% of azoospermic males even after aggressive open surgical exploration like Micro-TESE we will not be able to retrieve sperms.…”

Sperm recovery and IVF outcome after surgical sperm retrieval in azoospermia: our experience

“…In OA both reconstructive procedures and surgical retrieval are highly successful. [6][7][8] Non-Obstructive azoospermia (NOA) is associated with a spectrum of various severe and untreatable conditions associated with an intrinsic testicular impairment. 9 Parameters like history, physical examination, testicular volume and hormonal analysis (FSH, LH, TSH, Testosterone) and even the histology of a diagnostic biopsy are only indicative and not always predictive in diagnosing the cause of azoospermia because patients with maturation arrest (MA) generally have welldeveloped and normal-sized testes and normal hormonal levels.…”

Role of Male Infertility in Assisted Reproductive Technology Programs (A Literature Review)

“…Среди всех видов азооспермий обструктивная фор-ма встречается в 40 % случаев и является наиболее благоприятной для исходов программ ВРТ [54]. В ме-таанализе, проведенном J. D. M. Nicopoullos и соавт.…”