Sperm recovery and ICSI outcomes in non-obstructive azoospermia with cryptorchidism treated by orchiopexy: a systematic review and meta-analysis.

The aim of this meta-analysis was to quantify the available data concerning sperm retrieval rate (SRR) subsequent to testicular sperm extraction (TESE) and the clinical pregnancy rate (CPR) and live birth rate (LBR) subsequent to TESE and intracytoplasmic sperm injection (ICSI) in patients with non-obstructive azoospermia with cryptorchidism treated by orchidopexy. Furthermore, the aim was to explore the potential predictors of SRR, CPR and LBR within this population. Extensive searches were conducted in PubMed, Embase, Cochrane and Web of Science databases, and 23 articles were included in the study, with 1496 patients. The overall SRR per TESE cycle in the total evaluated trials was 60.9% (55.7-66.2%). Factors such as age at TESE, age at orchidopexy, testicular volume, and FSH, LH and testosterone levels did not affect final SRR. Meta-analyses were conducted on 13 studies each for CPR and LBR, including 913 and 799 ICSI cycles, respectively. The overall CPR per ICSI cycle was 37.6% (29.1-46.1%), and the overall LBR per ICSI cycle was 32.6% (24.9-40.4%). Factors as mentioned above, and the age of women undergoing ICSI, did not affect CPR or LBR per ICSI cycle. Although this meta-analysis extensively investigated outcomes of TESE and potential predictors of SRR, CPR and LBR for patients with non-obstructive azoospermia with cryptorchidism treated by orchidopexy, no effective predictors of outcomes were identified.