Outcomes of in vitro fertilization (IVF) using intracytoplasmic sperm injection (ICSI) with sperm retrieved via percutaneous epididymal sperm aspiration (PESA) and microdissection testicular sperm extraction (micro-tese)
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Abstract
This study compared the clinical outcomes of sperm retrieved via percutaneous epididymal sperm aspiration (PESA) in patients with obstructive azoospermia and microdissection testicular sperm extraction (micro-TESE) in patients with non-obstructive azoospermia. A retrospective cohort study was conducted on 69 ICSI cycles at Vinmec Times City International Hospital from January 2021 to December 2024. Subjects were divided into two groups: PESA (n = 49) and micro-TESE (n = 20). Primary outcomes included fertilization rate (FR), day 3 top-quality embryo rate, and live birth rate (LBR). The fertilization rate in the PESA group was significantly higher than in the micro-TESE group (88.2% vs. 79.8%, p < 0.05). However, the day 3 top-quality embryo rate was comparable between the two groups (54.6% vs. 51.7%, p > 0.05). Clinical outcomes showed that the live birth rate in the micro-TESE group reached 30.0%, with no statistically significant difference compared to the PESA group (34.7%, p > 0.05). Although sperm obtained from micro-TESE yielded a lower fertilization rate, the subsequent embryo quality and live birth rates were equivalent to those of the PESA group. As such, micro-TESE remains an effective and safe method, providing a favorable prognosis for patients with non-obstructive azoospermia in the modern ICSI era.
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Keywords
ICSI, PESA, Micro-TESE, azoospermia, live birth rate, assisted reproduction
References
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