P-004 Sperm concentration of less than 1 million/ml in Y microdeletion patients may affect ICSI clinical outcomes: a propensity score matching analysis

Abstract

Abstract Study question To investigate which semen parameter in AZFc microdeletion patients affect the intracytoplasmic sperm injection (ICSI) clinical outcomes. Summary answer AZF-microdeletion caused oligospermia affected the ICSI clinical outcome when the sperm concentration is less than 1x106/ml. What is known already To reduce the impact of female factors on clinical outcomes, this study employed a propensity score matching analysis to retrospectively analyze the laboratory and clinical pregnancy results of patients with AZFc deletion who underwent ICSI. Study design, size, duration A propensity score matching analysis in a retrospective ICSI cohort of 99 AZFc microdeletion patients and 198 oligospermia patients without AZFc microdeletion. Participants/materials, setting, methods Patients/Animals: oligospermia patients with or without AZFc microdeletion undergoing ICSI. Intervention: ICSI for couples attempting conception. Main Outcome Measures: Outcomes included normal fertilization rate, high-quality embryo rate on Day 3, clinical pregnancy rate, abortion rate, and live birth rate. Main results and the role of chance Patients with AZFc microdeletion had a lower normal fertilization rate (69.55%) and Day-3 high-quality embryo rate (50.73%) than the control group (77.17% and 58.44% respectively, p = 0.000). There was no significant difference between the two groups in the clinical pregnancy rate (67.21% vs. 68.16%, p > 0.05), miscarriage rate (13.41% vs. 12.54%, p > 0.05), and live birth rate (58.20% vs. 59.18%, p > 0.05). Subgroup analysis showed that the fertilization rate, high-quality embryo rate, clinical pregnancy rate, and live birth rate were comparable between the AZFc-microdeletion group and the control groups when the sperm concentration was no less than 106/ml. Interestingly, when the sperm concentration was below 1x106/ml, the fertilization rate (65.60% vs. 73.79%, p = 0.001) and high-quality embryo rate (47.74% vs. 58.48%, p = 0.001) in the AZFc-microdeletion group were significantly lower than those in the control group. Furthermore, the clinical pregnancy rate and live birth rate were lower, while the miscarriage rate was higher in the AZFc-microdeletion group; however, the statistical difference is not significant. Limitations, reasons for caution the retrospective study was limited, and the cases of obtaining testicular sperm by microsurgery were not included, so the results may be biased, and prospective studies with larger sample size need to be designed for further confirmation. Wider implications of the findings We recommend screening for AZF in Chinese male infertile population when sperm concentration is below 5X106/ml.The male physician should advise the patient to undergo genetic counseling before pregnancy assistance, and choose whether to choose PGT assisted pregnancy according to the patient's wishes. Trial registration number not applicable