[Results of micro-TESE and outcomes of ICSI in patients with different etiological types of non-obstructive azoospermia].

Objective: To compare the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (micro-TESE) and the outcomes of intracytoplasmic sperm injection (ICSI) among different etiological types of non-obstructive azoospermia (NOA).

Methods: We retrospectively analyzed the clinical data on 155 cases of NOA undergoing micro-TESE in our hospital from September 2016 to December 2017, which were classified into three types according to etiological factors: congenital NOA (n = 49), acquired NOA (n = 15) and idiopathic NOA (n = 91). We compared the age, testis volume, levels of reproductive hormones, ultrasonographic manifestations, and SRR of micro-TESE among the three groups of patients. We also recorded and analyzed the rates of fertilization, available embryos and clinical pregnancy in the spouses of the patients included for successful sperm retrieval in micro-TESE.

Results: The testis volume was significantly lower in the congenital than in the acquired and idiopathic NOA groups (［6.4 ± 5.0］ vs ［10.2 ± 2.0］ and ［9.9 ± 3.2］ ml, P < 0.05), while the LH level was markedly higher in the former group than in the latter two (［15.2 ± 10.1］ vs ［9.1 ± 6.5］ and ［7.8 ± 3.5］ mIU/ml, P < 0.05), and so was the T level in the idiopathic than in the congenital NOA group (［11.8 ± 4.8］ vs ［8.9 ± 4.5］ nmol /L, P < 0.05). The SRRs of micro-TESE in the congenital, acquired and idiopathic NOA patients were 73.5% (36/49), 100% (15/15), and 24.2% (22/91) respectively, with statistically significant differences among the three groups (P < 0.05). The fertilization rate after ICSI was remarkably higher in the acquired than in the congenital and idiopathic NOA groups (［73.1±23.3］% vs ［48.9±21.7］% and ［52.6±22.7］%, P < 0.05). There were no statistically significant differences among the three groups in the rates of embryo utilization and clinical pregnancy.

Conclusions: The sperm retrieval rate of micro-TESE and the rates of fertilization, embryo utilization and clinical pregnancy after ICSI were the highest in the acquired NOA but the lowest in the idiopathic NOA patients.