Spermatogenesis induction audit over a 5-year period at a UK male fertility centre

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Background: This audit aimed to evaluate and measure the outcomes of spermatogenesis induction over a 5-year period. Men with primary, as well as central hypogonadism, received gonadotrophin therapy to stimulate sperm production and fertility outcomes, including live birth rates. Predictors associated with live births, were measured retrospectively. Methods: Men with severe oligospermia (sperm concentration <5million/ml), having gonadotrophin prescriptions for a minimum of 6 months, were identified via the electronic prescription system. They were asked to complete a service evaluation questionnaire. Results: Men with persistent azoospermia were more likely to have a diagnosis of PH (Odds ratio 22.5, p<0.001) and smaller testicular size (Odds ratio 8.8, p<0.001), compared to men with successful spermatogenesis. Twenty-eight per cent (13/47) had partners, who conceived spontaneously and delivered healthy babies. Nine per cent (4/47) had a live birth after ART. Live birth rate was higher in men with CH compared to PH, with 17 of 45 (38%) men with CH having a partner that successfully delivered a baby. Conclusion: Men with mainly central hypogonadism and female partners with no known subfertility are most likely to achieve conception and live birth. Patient education on the results of semen analysis or female factors affecting fertility could improve overall outcomes.