Clinical outcomes of microdissection testicular sperm extraction and intracytoplasmic sperm injection in Japanese men with Y chromosome microdeletions
Kohei Yamaguchi, Tomomoto Ishikawa, Shimpei Mizuta, Takumi Takeuchi, Hidehiko Matsubayashi, Shoji Kokeguchi, Toshihiro Habara, Kentaro Ichioka, Masakazu Ohashi, Sumihide Okamoto, Toshihiro Kawamura, Satoru Kanto, Hisanori Taniguchi, Fumiko Tawara, Tetsuaki Hara, Hatsuki Hibi, Hiroshi Masuda, Takehiko Matsuyama, Hiroaki Yoshida
Abstract
Abstract Purpose We investigated the clinical results of Japanese men with Y chromosome microdeletions. Methods This study retrospectively examined 2163 azoospermic or severe oligozoospermic patients. We investigated the frequency of azoospermia factor (AZF) deletions and sperm retrieval rate (SRR) by microTESE in patients with these deletions, then analyzed the ICSI outcomes. Results Azoospermia factor deletions were found in 201 patients. SRR was significantly higher than that of the control group (74.0% vs 20.4%, P < .001). Thirty‐three couples underwent ICSI using testicular spermatozoa retrieved by microTESE, and eight couples underwent ICSI using ejaculatory spermatozoa. The fertilization rate and clinical pregnancy rate per embryo transfer cycle were significantly higher in the ejaculatory group than that of the testicular group (66.4% vs 43.7%, P < .001, 53.3% vs 24.7%, P = .03, respectively). When compared with the control group, the fertilization rate was significantly lower in the testicular group with AZFc microdeletions (43.7% vs 53.6%, P < .001). Conclusions Our study highlights that although microTESE in azoospermic men with AZFc microdeletions led to a higher SRR, ICSI outcomes of these men were worse than that of men without AZF deletions, even if testicular spermatozoa were retrieved.