Comparison of ART outcome between non-obstructive azoospermia and obstructive azoospermia: 15 years experiences

Abstract

ObjectiveThe introduction of ICSI has revolutionized the treatment of severe male infertility. Moreover, ICSI using testicular spermatozoa has been commonly applied in the treatment of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). However, some authors describe similar and high fertilization and pregnancy rates in NOA patients whereas others report lower outcomes in NOA than in OA patients. In this study, we evaluated the differences on ART outcome after ICSI with frozen-thawed testicular spermatozoa between NOA and OA.DesignThis is a retrospective study from 1999 to 2013.Materials and MethodsMultiple testicular biopsy or micro-dissection TESE was performed in NOA patients while simple testicular biopsy was performed in OA patients. ICSI was performed with frozen-thawed testicular spermatozoa from NOA or OA. The ART outcome in the NOA group (4,295 oocytes, 317 cycles) and the OA group (4,187 oocytes, 336 cycles) were compared.ResultsThe wife’s average age and the number of the oocytes retrieved of both groups did not have the significant difference. However, the normal fertilization rate in the NOA group (67.9%) was significantly lower than that in the OA group (77.0%). The average number of embryo transferred was comparable between the two groups. And, the pregnancy rate and the implantation rate did not have the significant difference between the two groups. However, the delivery rate in the NOA group was significantly lower than that in the OA group (32.3% vs 40.8%). The mean birth weight in the NOA group (2953.5±487.9g) was comparable with that in the OA group (2997.3±356.9g). The malformation rate was almost same between the two groups.ConclusionThe normal fertilization rate and the delivery rate in the NOA group were significantly lower than those in the OA group. ObjectiveThe introduction of ICSI has revolutionized the treatment of severe male infertility. Moreover, ICSI using testicular spermatozoa has been commonly applied in the treatment of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). However, some authors describe similar and high fertilization and pregnancy rates in NOA patients whereas others report lower outcomes in NOA than in OA patients. In this study, we evaluated the differences on ART outcome after ICSI with frozen-thawed testicular spermatozoa between NOA and OA. The introduction of ICSI has revolutionized the treatment of severe male infertility. Moreover, ICSI using testicular spermatozoa has been commonly applied in the treatment of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). However, some authors describe similar and high fertilization and pregnancy rates in NOA patients whereas others report lower outcomes in NOA than in OA patients. In this study, we evaluated the differences on ART outcome after ICSI with frozen-thawed testicular spermatozoa between NOA and OA. DesignThis is a retrospective study from 1999 to 2013. This is a retrospective study from 1999 to 2013. Materials and MethodsMultiple testicular biopsy or micro-dissection TESE was performed in NOA patients while simple testicular biopsy was performed in OA patients. ICSI was performed with frozen-thawed testicular spermatozoa from NOA or OA. The ART outcome in the NOA group (4,295 oocytes, 317 cycles) and the OA group (4,187 oocytes, 336 cycles) were compared. Multiple testicular biopsy or micro-dissection TESE was performed in NOA patients while simple testicular biopsy was performed in OA patients. ICSI was performed with frozen-thawed testicular spermatozoa from NOA or OA. The ART outcome in the NOA group (4,295 oocytes, 317 cycles) and the OA group (4,187 oocytes, 336 cycles) were compared. ResultsThe wife’s average age and the number of the oocytes retrieved of both groups did not have the significant difference. However, the normal fertilization rate in the NOA group (67.9%) was significantly lower than that in the OA group (77.0%). The average number of embryo transferred was comparable between the two groups. And, the pregnancy rate and the implantation rate did not have the significant difference between the two groups. However, the delivery rate in the NOA group was significantly lower than that in the OA group (32.3% vs 40.8%). The mean birth weight in the NOA group (2953.5±487.9g) was comparable with that in the OA group (2997.3±356.9g). The malformation rate was almost same between the two groups. The wife’s average age and the number of the oocytes retrieved of both groups did not have the significant difference. However, the normal fertilization rate in the NOA group (67.9%) was significantly lower than that in the OA group (77.0%). The average number of embryo transferred was comparable between the two groups. And, the pregnancy rate and the implantation rate did not have the significant difference between the two groups. However, the delivery rate in the NOA group was significantly lower than that in the OA group (32.3% vs 40.8%). The mean birth weight in the NOA group (2953.5±487.9g) was comparable with that in the OA group (2997.3±356.9g). The malformation rate was almost same between the two groups. ConclusionThe normal fertilization rate and the delivery rate in the NOA group were significantly lower than those in the OA group. The normal fertilization rate and the delivery rate in the NOA group were significantly lower than those in the OA group.