Poor intracytoplasmic sperm injection outcome in infertile males with azoospermia factor c microdeletions

Objective: To explore whether the presence of azoospermia factor c (AZFc) microdeletions adversely affects intracytoplasmic sperm injection (ICSI) outcome. Design: Retrospective cohort. Setting: University hospital. Patient(s): A total of 293 patients with azoospermia or severe oligozoospermia AZFc deletions underwent 345 ICSI cycles, and 363 idiopathic patients with normal Y chromosome underwent 462 ICSI cycles. Intervention(s): Testicular sperm aspiration, microdissection testicular sperm extraction. Main Outcome Measure(s): The main clinical outcome parameters were cumulative clinical pregnancy rate, cumulative live birth delivery rate, and no embryo suitable for transfer cycle rate. Result(s): Compared with the control group, the AZFc deletion group exhibited poorer ICSI outcome, with significant differences between the 2 groups for cumulative clinical pregnancy rate (45.39% vs. 67.49%; odds ratio [OR], 2.843; 95% confidence interval [CI]), cumulative live birth delivery rate (35.15% vs. 53.44%; OR, 2.234; 95% CI), no embryo suitable for transfer cycle rate (15.07% vs. 8.23%; OR, 0.565; 95% CI), fertilization rate (46.80% vs. 53.37%; adjusted beta, -0.074; 95% CI), implantation rate (28.63% vs. 31.26%; adjusted beta, -0.075; 95% CI) separately. The poor ICSI outcome of the AZFc deletion group was related to AZFc microdeletions by linear and logistic regression analyses. Conclusion(s): AZFc microdeletions adversely affect ICSI outcome; patients with AZFc deletion should be informed that they have reduced opportunities to be biological fathers. (C) 2021 by American Society for Reproductive Medicine.

Automated summary

The presence of AZFc microdeletions resulted in poorer outcomes in intracytoplasmic sperm injection (ICSI), with lower pregnancy and live birth rates compared to control groups. Patients with these deletions should be aware of their reduced chances of biological fatherhood.