Abstract：
BACKGROUND: Non-obstructive azoospermia (NOA) diagnosis poses challenges for couples seeking parenthood. Microdissection testicular sperm extraction (MD-TESE) excels in retrieving testicular sperm cells for NOA cases. However, limited live birth data in Australian NOA patients hinders accurate counselling.
OBJECTIVE: This study aimed to determine the likelihood of infertile couples with a male partner diagnosed with NOA conceiving biological children using MD-TESE / intracytoplasmic sperm injection (ICSI).
METHODS: A retrospective cohort study included 108 NOA men treated at a public fertility unit and a private fertility centre (May 2009-May 2022).
METHODS: live birth rate (LBR); secondary outcomes: sperm retrieval rate, pregnancy rate, and neonatal outcomes.
RESULTS: Among 108 patients undergoing MD-TESE, the positive sperm retrieval rate (PSRR) was 64.8% (70/108). Histology best predicted sperm retrieval success, with hypo-spermatogenesis yielding a 94.1% PSRR. Age, testicular volume, and hormonal parameters had no significant impact. Mean male age: 35.4 years; mean partner age: 32.7 years. Fertilisation rate: 50.7%. LBR per initiated cycle: 58.7% (37/63); per embryo transfer: 63.8% (37/58); per initially diagnosed NOA man: 34.3% (37/108). Cumulative LBR: 74.1% (43/58); twin rate: 10.8% (4/37). No neonatal deaths or defects were observed among 47 live offspring.
CONCLUSIONS: This study provides valuable data for counselling NOA couples on the probability of conceiving biological offspring. MD-TESE and ICSI yielded favourable PSRR (64.8%) and LBR (63.8%). However, couples should be aware that once NOA is confirmed, the chance of taking home a baby is 34%.
OBJECTIVE: This study aimed to determine the likelihood of infertile couples with a male partner diagnosed with NOA conceiving biological children using MD-TESE / intracytoplasmic sperm injection (ICSI).
METHODS: A retrospective cohort study included 108 NOA men treated at a public fertility unit and a private fertility centre (May 2009-May 2022).
METHODS: live birth rate (LBR); secondary outcomes: sperm retrieval rate, pregnancy rate, and neonatal outcomes.
RESULTS: Among 108 patients undergoing MD-TESE, the positive sperm retrieval rate (PSRR) was 64.8% (70/108). Histology best predicted sperm retrieval success, with hypo-spermatogenesis yielding a 94.1% PSRR. Age, testicular volume, and hormonal parameters had no significant impact. Mean male age: 35.4 years; mean partner age: 32.7 years. Fertilisation rate: 50.7%. LBR per initiated cycle: 58.7% (37/63); per embryo transfer: 63.8% (37/58); per initially diagnosed NOA man: 34.3% (37/108). Cumulative LBR: 74.1% (43/58); twin rate: 10.8% (4/37). No neonatal deaths or defects were observed among 47 live offspring.
CONCLUSIONS: This study provides valuable data for counselling NOA couples on the probability of conceiving biological offspring. MD-TESE and ICSI yielded favourable PSRR (64.8%) and LBR (63.8%). However, couples should be aware that once NOA is confirmed, the chance of taking home a baby is 34%.
摘要：
背景：非梗阻性无精子症（NOA）的诊断对寻求父母的夫妇提出了挑战。显微解剖睾丸精子提取（MD-TESE）在NOA病例的睾丸精子细胞检索方面表现出色。然而,澳大利亚NOA患者有限的活产数据阻碍了准确的咨询.
目的：本研究旨在通过MD-TESE/卵胞浆内单精子注射（ICSI），确定男性伴侣诊断为NOA的不育夫妇怀孕生子的可能性。
方法：一项回顾性队列研究包括108名在公共生育单位和私人生育中心接受治疗的NOA男性（2009年5月至2022年5月）。
方法：活产率（LBR）；次要结局：精子提取率，怀孕率,和新生儿结局。
结果：在108例接受MD-TESE的患者中，阳性精子恢复率（PSRR）为64.8％（70/108）。组织学最好的预测精子回收成功，精子发生减少产生94.1％的PSRR。年龄,睾丸体积,和激素参数没有显著影响。男性平均年龄：35.4岁；伴侣平均年龄：32.7岁。受精率：50.7%。每个起始周期的LBR：58.7%（37/63）；每个胚胎移植：63.8%（37/58）；每个最初诊断为NOA的人：34.3%（37/108）。累计LBR：74.1%（43/58）；双胎率：10.8%（4/37）。在47个存活的后代中未观察到新生儿死亡或缺陷。
结论：这项研究提供了有价值的数据，为NOA夫妇提供关于受孕生物后代的可能性的咨询。MD-TESE和ICSI产生了有利的PSRR（64.8%）和LBR（63.8%）。然而,夫妇应该知道，一旦NOA被确认，带孩子回家的机会是34%。
目的：本研究旨在通过MD-TESE/卵胞浆内单精子注射（ICSI），确定男性伴侣诊断为NOA的不育夫妇怀孕生子的可能性。
方法：一项回顾性队列研究包括108名在公共生育单位和私人生育中心接受治疗的NOA男性（2009年5月至2022年5月）。
方法：活产率（LBR）；次要结局：精子提取率，怀孕率,和新生儿结局。
结果：在108例接受MD-TESE的患者中，阳性精子恢复率（PSRR）为64.8％（70/108）。组织学最好的预测精子回收成功，精子发生减少产生94.1％的PSRR。年龄,睾丸体积,和激素参数没有显著影响。男性平均年龄：35.4岁；伴侣平均年龄：32.7岁。受精率：50.7%。每个起始周期的LBR：58.7%（37/63）；每个胚胎移植：63.8%（37/58）；每个最初诊断为NOA的人：34.3%（37/108）。累计LBR：74.1%（43/58）；双胎率：10.8%（4/37）。在47个存活的后代中未观察到新生儿死亡或缺陷。
结论：这项研究提供了有价值的数据，为NOA夫妇提供关于受孕生物后代的可能性的咨询。MD-TESE和ICSI产生了有利的PSRR（64.8%）和LBR（63.8%）。然而,夫妇应该知道，一旦NOA被确认，带孩子回家的机会是34%。
