Abstract：
To investigate whether Azoospermia Factor c (AZFc) microdeletions affect Assisted Reproductive Technology (ART) outcomes.
Systematic review and meta-analysis.
Not applicable.
Infertile men with and without AZFc microdeletions.
Electronic databases were searched for case-control studies reporting sperm retrieval rates and outcomes of ART in infertile men with and without AZFc microdeletions from inception to April 2023. Study quality was assessed using the Newcastle-Ottawa Scale. Summary effect sizes (odds ratio [OR] with 95% confidence interval [CI]) were calculated for both categories of infertile men.
The primary outcome was successful sperm retrieval and the secondary outcomes were outcomes of ART.
Case-control studies reporting sperm retrieval rates and ART outcomes in men with AZFa and AZFb deletions were unavailable. On the basis of the data from 3,807 men, sperm retrieval rates were found to be higher in men with AZFc microdeletions compared to their non-deleted counterparts [OR = 1.82, 95% CI 0.97, 3.41], but the difference was not statistically significant. A significantly lower fertilization rate (OR = 0.61, 95% CI [0.50, 0.74]), clinical pregnancy rate (OR = 0.61, 95% CI [0.42, 0.89]), and live birth rate (OR = 0.54, 95% CI [0.40, 0.72]) were observed in men with AZFc deletions compared with men without deletions. There was no statistically significant difference in rates of embryo cleavage, blastocyst formation, good-quality embryos, implantation, and miscarriage between the two groups. On correcting for female factors, the fertilization rate (OR = 0.76, 95% CI [0.71, 0.82]), cleavage rate (OR = 0.54, 95% CI [0.41, 0.72]), clinical pregnancy rate (OR = 0.39, 95% CI [0.30, 0.52]), and live birth rate (OR = 0.48, 95% CI [0.35, 0.65]) were significantly lower in men with AZFc deletions compared with controls.
Presence of AZFc microdeletions adversely affects outcomes of ART in infertile men. Further in-depth studies delineating the role of the AZF genes in embryonic development are necessary to understand the full-impact of this finding.
CRD42022311738.
Systematic review and meta-analysis.
Not applicable.
Infertile men with and without AZFc microdeletions.
Electronic databases were searched for case-control studies reporting sperm retrieval rates and outcomes of ART in infertile men with and without AZFc microdeletions from inception to April 2023. Study quality was assessed using the Newcastle-Ottawa Scale. Summary effect sizes (odds ratio [OR] with 95% confidence interval [CI]) were calculated for both categories of infertile men.
The primary outcome was successful sperm retrieval and the secondary outcomes were outcomes of ART.
Case-control studies reporting sperm retrieval rates and ART outcomes in men with AZFa and AZFb deletions were unavailable. On the basis of the data from 3,807 men, sperm retrieval rates were found to be higher in men with AZFc microdeletions compared to their non-deleted counterparts [OR = 1.82, 95% CI 0.97, 3.41], but the difference was not statistically significant. A significantly lower fertilization rate (OR = 0.61, 95% CI [0.50, 0.74]), clinical pregnancy rate (OR = 0.61, 95% CI [0.42, 0.89]), and live birth rate (OR = 0.54, 95% CI [0.40, 0.72]) were observed in men with AZFc deletions compared with men without deletions. There was no statistically significant difference in rates of embryo cleavage, blastocyst formation, good-quality embryos, implantation, and miscarriage between the two groups. On correcting for female factors, the fertilization rate (OR = 0.76, 95% CI [0.71, 0.82]), cleavage rate (OR = 0.54, 95% CI [0.41, 0.72]), clinical pregnancy rate (OR = 0.39, 95% CI [0.30, 0.52]), and live birth rate (OR = 0.48, 95% CI [0.35, 0.65]) were significantly lower in men with AZFc deletions compared with controls.
Presence of AZFc microdeletions adversely affects outcomes of ART in infertile men. Further in-depth studies delineating the role of the AZF genes in embryonic development are necessary to understand the full-impact of this finding.
CRD42022311738.
摘要：
目的：关于AZFc微缺失对精子回收和ART结局的影响的现有证据有限且本质上相互矛盾。目的：调查AZFc微缺失是否会影响辅助生殖技术（ART）结局数据来源：搜索电子数据库，以调查从开始到2023年4月AZFc微缺失与ART结局的相关性研究。研究选择和综合：分析了病例对照研究。研究人群包括有和没有AZFc微缺失的不育男性。使用纽卡斯尔-渥太华量表评估研究质量。计算这两类男性的总效应大小(比值比[OR]和95%置信区间[CI])。
结果：主要结局是成功取出精子，次要结局是ART结局。
结果：(S)：没有病例对照研究报告AZFa和AZFb缺失男性的精子获取率和ART结果。根据3807名男性的数据，AZFc微缺失男性的精子回收率高于未缺失男性[OR=1.82,95%CI0.97,3.41],但差异无统计学意义(P=0.06).受精率显著降低(OR=0.61,95%CI0.50,0.74),与无缺失男性相比,有AZFc缺失男性的临床妊娠率(OR=0.61,95%CI0.42,0.89)和活产率(OR=0.54,95%CI0.40,0.72).胚胎卵裂率无统计学差异，囊胚形成,优质胚胎,两组之间的植入和流产。关于纠正女性因素，受精率(OR=0.76，95%CI0.71，0.82)，卵裂率(OR=0.54，95%CI0.41，0.72)，AZFc缺失男性的临床妊娠率(OR=0.39,95%CI0.30,0.52)和活产率(OR=0.48,95%CI0.35,0.65)显著低于对照组.
结论：(S)和相关性：AZFc微缺失与ART的不良结局显著相关。需要进一步的研究来准确阐明AZFc微缺失对ART结果的影响。
结果：主要结局是成功取出精子，次要结局是ART结局。
结果：(S)：没有病例对照研究报告AZFa和AZFb缺失男性的精子获取率和ART结果。根据3807名男性的数据，AZFc微缺失男性的精子回收率高于未缺失男性[OR=1.82,95%CI0.97,3.41],但差异无统计学意义(P=0.06).受精率显著降低(OR=0.61,95%CI0.50,0.74),与无缺失男性相比,有AZFc缺失男性的临床妊娠率(OR=0.61,95%CI0.42,0.89)和活产率(OR=0.54,95%CI0.40,0.72).胚胎卵裂率无统计学差异，囊胚形成,优质胚胎,两组之间的植入和流产。关于纠正女性因素，受精率(OR=0.76，95%CI0.71，0.82)，卵裂率(OR=0.54，95%CI0.41，0.72)，AZFc缺失男性的临床妊娠率(OR=0.39,95%CI0.30,0.52)和活产率(OR=0.48,95%CI0.35,0.65)显著低于对照组.
结论：(S)和相关性：AZFc微缺失与ART的不良结局显著相关。需要进一步的研究来准确阐明AZFc微缺失对ART结果的影响。
