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Factors predicting the outcome of percutaneous epididymal sperm aspiration in men with obstructive azoospermia

Authors

Khaled Mohamed Almekaty
Tanta University Hospital, Urology Department, Tanta, Egypt.
Mohamed Hasan Zahran
Mansoura Urology-Nephrology Centre, Urology Department, Mansoura, Egypt.
Mohamed Lotfy Amer
Tanta University Hospital, Urology Department, Tanta, Egypt.
Ayman Mohamed Hagras
Tanta University Hospital, Urology Department, Tanta, Egypt.
Khaled Abdelaziz Salem
Tanta University Hospital, Urology Department, Tanta, Egypt.
Ayman Sayed Rashed
October 6 University, Faculty of Medicine, Department of Urology, Cairo, Egypt.
Ahmed Fayez Ghaith
dr_ahmedfayez@yahoo.com
https://orcid.org/0000-0002-9102-1821
Tanta University Hospital, Urology Department, Tanta, Egypt.

Objectives: To report on the live birth rates (LBRs) following percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia (OA) and factors affecting treatment outcome which is under reported in the literature.
Methods: This is a multicenter study that was conducted in Egypt including all couples undergoing intra cytoplasmic sperm injection (ICSI) for OA using PESA-derived sperms. Men were subdivided according to aetiology into congenital, iatrogenic and idiopathic groups. Fertilization, pregnancy and LBRs were determined and compared in each group. The longitudinal LBR, crude and expected cumulative delivery rates (CCDR, ECDR) were calculated. Multiple logistic regression analysis was used to determine significant associations between maternal, paternal and ICSI factors with successful live births.
Results: Ninety couples were included in the study. Viable sperm for ICSI was retrieved in 89 men (98.9%). A total of 155 ICSI cycles with 17 frozen embryo transfers resulted in 81 pregnan-cies and 55 live births. After 5 cycles, the longitudinal LBR, CCDR and ECDR were 30%, 57.3% and 88.6% respectively. Maternal age and number of fertilized eggs were the only fac-tors significantly affecting LBRs.
Conclusions: PESA is a minimally invasive procedure for secur-ing viable sperm for ICSI in OA men, with high cumulative delivery rates. Maternal age and number of fertilized eggs are the only factors that significantly affecting LBR. The contempo-rary longitudinal and cumulative LBRs provide objective out-come data to counsel OA patients undergoing fertility treat-ments.

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How to Cite

Almekaty, K. M., Zahran, M. H., Lotfy Amer, M., Hagras, A. M., Salem, K. A., Rashed, A. S., & Ghaith, A. F. (2022). Factors predicting the outcome of percutaneous epididymal sperm aspiration in men with obstructive azoospermia. Archivio Italiano Di Urologia E Andrologia, 94(3), 323–327. https://doi.org/10.4081/aiua.2022.3.323

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