TESE-ICSI outcomes per couple in vasectomized males are negatively affected by time since the intervention, but not other comorbidities
Reprod BioMed Online. May.
2021 doi: 10.1016/j.rbmo.2021.05.013
Research question: The study aimed to evaluate if the time since vasectomy (as obstructive interval) and the presence of different male comorbidities adversely affect the likelihood of achieving a newborn of vasectomized males undergoing testicular sperm extraction (TESE) and ICSI. Design: This retrospective study included 364 couples with vasectomized males undergoing TESE-ICSI cycles with autologous oocytes at IVI Valencia. The main outcome was the cumulative live birth rate (CLBR). Subjects were divided according to the male risk factor evaluated into quartiles (obstructive interval, body mass index) or groups (hypertension, diabetes mellitus, dyslipidemia). The reproductive outcomes were calculated per embryo transfer (ET), per controlled ovarian stimulation (COS) completed, and per couple. Results: The average obstructive interval was 11.3 years. The LBR was 34.0% (95%CI 29.8-38.2) per ET, 27.8% (95%CI 24.1-31.5) per COS and 46.2% (95%CI 41.8-51.3) per couple. When considering obstructive interval, a significantly lower LBR per couple was found in the group with the longest obstruction time: Q1:42.1% (95%CI 33.5-50.7), Q2:49.1% (95%CI 36.1-62.1), Q3:56.3% (95%CI 46.7-65.9), and Q4:37.2% (95%CI 26.5-47.9) but the CLBR was not affected (p>0.05). LBR per COS of males with hypertension was significantly lower than healthy males, 13.5% (95%CI 2.5-24.5) and 28.6% (95%CI 24.7-32.5), respectively. The group of diabetic-vasectomized males had a significantly higher CLBR. The remaining risk factors assessed did not affect LBR compared to their healthy counterparts. Conclusion: Time since vasectomy appears to negatively influence the live birth rate when assessed per couple. The CLBR was not affected by the obstructive interval or the presence of other male comorbidities. Keywords: Comorbidities, Cumulative live birth rates, TESE, ICSI, Testicular sperm, Vasectomy