Abstract：
BACKGROUND: Vasectomy is a widely used method of contraception. However, some men may have the desire to become biological fathers again after a period.
OBJECTIVE: To explore the effect of time since vasectomy and different male comorbidities on live birth rates from intracytoplasmic sperm injection cycles using donated oocytes by using testicular spermatozoa obtained by testicular sperm extraction.
METHODS: This was a retrospective study of 123 couples who underwent a testicular sperm extraction‒intracytoplasmic sperm injection cycle after vasectomy using donated oocytes. Subjects were divided into groups according to time since vasectomy and the male risk factor evaluated. The main outcomes measured were live birth rate per embryo transfer, per oocyte donation cycle, and per couple. We assessed the cumulative live birth rate according to the time since vasectomy and considered male comorbidities: body mass index, hypertension, diabetes mellitus, dyslipidemia, and smoking.
RESULTS: The overall live birth rate per couple was 59.3% (50.6-68.0). Considering the number of embryo transfer and oocyte donation cycle, the live birth rates were 34.1% (27.8-40.4) and 44.5% (36.9-52.1), respectively. The live birth rate according to time since vasectomy was not statistically different between groups. Consequently, the cumulative live birth rate was similar between the different interval times when considering one to eight embryo transfers (p = 0.74). No statistical differences in live birth rate and cumulative live birth rate were found between groups clustered according to male body mass index, smoking, hypertension, and dyslipidemia. However, diabetic male patients had a significantly lower rate of live birth rate per couple (22.2% [4.94-49.4]) than non-diabetic patients did (62.7% [53.7-71.8]) (p = 0.03), but not in their cumulative live birth rate.
CONCLUSIONS: The time since vasectomy seems to have no detrimental effects on the live birth rate and cumulative live birth rate in testicular sperm extraction‒intracytoplasmic sperm injection cycles with donated oocytes. Male diabetes negatively affects the overall live birth rate per couple, but not the cumulative live birth rate. These results could be useful for multidisciplinary patient-tailored counseling, regarding the chance of having a pregnancy and facilitating the decision-making process of the fertility specialists.
OBJECTIVE: To explore the effect of time since vasectomy and different male comorbidities on live birth rates from intracytoplasmic sperm injection cycles using donated oocytes by using testicular spermatozoa obtained by testicular sperm extraction.
METHODS: This was a retrospective study of 123 couples who underwent a testicular sperm extraction‒intracytoplasmic sperm injection cycle after vasectomy using donated oocytes. Subjects were divided into groups according to time since vasectomy and the male risk factor evaluated. The main outcomes measured were live birth rate per embryo transfer, per oocyte donation cycle, and per couple. We assessed the cumulative live birth rate according to the time since vasectomy and considered male comorbidities: body mass index, hypertension, diabetes mellitus, dyslipidemia, and smoking.
RESULTS: The overall live birth rate per couple was 59.3% (50.6-68.0). Considering the number of embryo transfer and oocyte donation cycle, the live birth rates were 34.1% (27.8-40.4) and 44.5% (36.9-52.1), respectively. The live birth rate according to time since vasectomy was not statistically different between groups. Consequently, the cumulative live birth rate was similar between the different interval times when considering one to eight embryo transfers (p = 0.74). No statistical differences in live birth rate and cumulative live birth rate were found between groups clustered according to male body mass index, smoking, hypertension, and dyslipidemia. However, diabetic male patients had a significantly lower rate of live birth rate per couple (22.2% [4.94-49.4]) than non-diabetic patients did (62.7% [53.7-71.8]) (p = 0.03), but not in their cumulative live birth rate.
CONCLUSIONS: The time since vasectomy seems to have no detrimental effects on the live birth rate and cumulative live birth rate in testicular sperm extraction‒intracytoplasmic sperm injection cycles with donated oocytes. Male diabetes negatively affects the overall live birth rate per couple, but not the cumulative live birth rate. These results could be useful for multidisciplinary patient-tailored counseling, regarding the chance of having a pregnancy and facilitating the decision-making process of the fertility specialists.
摘要：
背景：输精管结扎术是一种广泛使用的避孕方法。然而,有些男人可能有一段时间后再次成为亲生父亲的愿望。
目的：通过使用睾丸精子提取获得的睾丸精子，研究输精管切除术后的时间和不同的男性合并症对卵胞浆内单精子注射周期活产率的影响。
方法：这是一项对123对夫妇的回顾性研究，他们在输精管切除术后使用捐赠的卵母细胞进行了睾丸精子提取-卵胞浆内精子注射周期。根据输精管切除术后的时间将受试者分组，并评估男性危险因素。测量的主要结果是每次胚胎移植的活产率，每个卵母细胞捐献周期，和每一对夫妇。我们根据输精管切除术后的时间评估了累积活产率，并考虑了男性合并症：体重指数，高血压,糖尿病,血脂异常,和吸烟。
结果：每对夫妇的总体活产率为59.3％（50.6-68.0）。考虑到胚胎移植和卵母细胞捐献周期的数量，活产率分别为34.1%(27.8-40.4)和44.5%(36.9-52.1),分别。两组之间的输精管切除术后的活产率没有统计学差异。因此,在考虑1~8个胚胎移植时,不同间隔时间的累积活产率相似(p=0.74).根据男性体重指数，各组之间的活产率和累积活产率没有统计学差异。吸烟,高血压,和血脂异常。然而,糖尿病男性患者每对夫妇的活产率（22.2%[4.94-49.4]）明显低于非糖尿病患者（62.7%[53.7-71.8]）（p=0.03），但不是他们的累计活产率。
结论：在睾丸精子提取-卵胞浆内单精子注射周期中，输精管切除术后的时间似乎对活产率和累积活产率没有不利影响。男性糖尿病对每对夫妇的总体活产率产生负面影响，但不是累计活产率。这些结果可能对多学科患者定制咨询有用，关于怀孕的机会和促进生育专家的决策过程。
目的：通过使用睾丸精子提取获得的睾丸精子，研究输精管切除术后的时间和不同的男性合并症对卵胞浆内单精子注射周期活产率的影响。
方法：这是一项对123对夫妇的回顾性研究，他们在输精管切除术后使用捐赠的卵母细胞进行了睾丸精子提取-卵胞浆内精子注射周期。根据输精管切除术后的时间将受试者分组，并评估男性危险因素。测量的主要结果是每次胚胎移植的活产率，每个卵母细胞捐献周期，和每一对夫妇。我们根据输精管切除术后的时间评估了累积活产率，并考虑了男性合并症：体重指数，高血压,糖尿病,血脂异常,和吸烟。
结果：每对夫妇的总体活产率为59.3％（50.6-68.0）。考虑到胚胎移植和卵母细胞捐献周期的数量，活产率分别为34.1%(27.8-40.4)和44.5%(36.9-52.1),分别。两组之间的输精管切除术后的活产率没有统计学差异。因此,在考虑1~8个胚胎移植时,不同间隔时间的累积活产率相似(p=0.74).根据男性体重指数，各组之间的活产率和累积活产率没有统计学差异。吸烟,高血压,和血脂异常。然而,糖尿病男性患者每对夫妇的活产率（22.2%[4.94-49.4]）明显低于非糖尿病患者（62.7%[53.7-71.8]）（p=0.03），但不是他们的累计活产率。
结论：在睾丸精子提取-卵胞浆内单精子注射周期中，输精管切除术后的时间似乎对活产率和累积活产率没有不利影响。男性糖尿病对每对夫妇的总体活产率产生负面影响，但不是累计活产率。这些结果可能对多学科患者定制咨询有用，关于怀孕的机会和促进生育专家的决策过程。
