The influence of obesity, smoking, and serum follicular stimulating hormone in azoospermic patients on testicular sperm extraction-intra cytoplasmic sperm injection outcomes

Abstract

To examine the effect of serum follicle-stimulating hormone (sFSH) level, body-mass index (BMI) and smoking on Testicular Sperm Extraction–Intracytoplasmic Sperm Injection (TESE–ICSI), and pregnancy outcomes.In this retrospective study, data were extracted from files of 52 azoospermic men who underwent TESE and in-vitro fertilization (IVF)-ICSI in our IVF unit. Demographic information, treatment cycle follow-up and pregnancy outcomes were collected.Fifty-two patients underwent 79 TESE due to azoospermia in 143 IVF cycles. Smoking was found to significantly affect sperm motility in TESE specimens before freezing (45.5% vs 14.8%; P <.001); however, this finding did not influence the pregnancy rate. Male FSH was inversely correlated with testicle volume (r = −0.595, P <.0001). Body weight did not affect semen parameters after TESE or ICSI outcomes.Among azoospermic patients with extremely poor sperm quality, male BMI, male FSH or smoking did not have an adverse effect sperm parameters or pregnancy and delivery rates.

Relationship Between Smoking Habit and Sperm Parameters Among Patients Attending an Infertility Clinic

“…This study has shown that an increase in age increases fertility, though some studies have been demonstrated that increasing paternal age is associated with decreased fertility rate (Shrem et al, 2019). Contrasting results of this study might be due to the fact that males aged 40–49 years found to be a 52% decrease in normal sperm motility, while it was markedly reduced by 79% at 50 years or older (Mariappen et al, 2018).…”

Easiness of sperms retrieval in non-obstructive azoospermia is a strong predictor of clinical pregnancy after intracytoplasmic sperm injection

“…In agreement with our finding, Wu et al [20] reported no correlation between paternal age and clinical pregnancy rate. In contrast, Shrem et al [21] had shown that paternal age above 37 years was significantly adversely correlated with clinical pregnancy. Besides, serum FSH levels of the females in the easy NOA group were significantly lower and had shown a significant correlation with clinical pregnancy than those in the difficult NOA group which could be explained by the fact that patients with elevated FSH levels are associated with decline in the quantity of the ovarian reserve with subsequent reduced pregnancy and live birth rates [22] .…”

“…In the same line, a study conducted by Guler et al [27] stated that testicular histopathology did not influence pregnancy rate in patients with NOA. Furthermore, Shrem et al [21] did not find any correlation between male FSH level and clinical pregnancy. On the contrary, a study conducted by Zitzmann et al [28] had shown that an FSH cutoff of 20 IU predicted pregnancy.…”

Obesity and Hypogonadism—A Narrative Review Highlighting the Need for High-Quality Data in Adolescents

“…There are also other mechanisms of reduced fertility in males that are associated with obesity, including inflammation that has been shown to reduce sperm quality and motility, reactive oxygen species that may cause, D.N.A. ; protein, and membrane damage in sperm cells, as well as epigenetic changes that contribute to subfertility [16,94,95,96,97,98,99,100]. These effects potentially contribute to long term subfertility for adolescent males with obesity who continue to have excess adipose tissue and experience hypogonadism in adulthood.…”