Pregnancy Rate In Non-Azoospermia With Normal Or Suboptimal Semen Parameter Versus Azoospermic Male Treated By IVF-ICSI Cycle

Abstract

Background: Intracytoplasmic sperm injection (ICSI) opens the gate for many cases of male factor infertility to be the biological fathers of their sibling since 1992. Most of cases were non-obstructive azoospermia and different levels of oligoastheno-teratozoospermia. Nowadays many cases of reduced semen parameter or female factor infertility are treated by IVF-ICSI Cycle for better pregnancy rate, biochemical and clinical, and live birth rate. Aim of the study: The study aims to compare biochemical, clinical pregnancy rate and outcome of pregnancies in the group with ejaculated sperm with normal or suboptimal semen parameter and group with non-obstructive azoospermia in whom sperm retrieved by TESE, using ICSI. Method: A retrospective cohort study was conducted between January, 2016 and February, 2023 in the fertility center of Al-Sader Medical City, a total of 372 couple, 90 of the males gave semen sample by masturbation and 282 of the males were non-obstructive azoospermia and their sperms were retrieved by TESE; all are treated by ICSI, all of their female partner were under age of 37 year, the maternal medical condition and obstetric history were not included in this study. Simple random sampling was depended, SPSS version 26 was used to perform the statistical analysis processes. Results: There was a highly significant difference in pregnancy rate by β.HCG between ejaculate group (43.3 %) and azoospermia (26.6 %) with p. value =0.003. A significant difference in clinical pregnancy rate by ultrasound between the ejaculate group (31.1%) and azoospermia (20.9%) with p. value =0.047. There was no statistically significant difference in live birth rate between ejaculate group as (24.4 %) and azoospermia as (17.4 %) with p.value=0.137. Conclusion: Freshly ejaculated sperm with normal or suboptimal semen parameter gave a better biochemical and clinical pregnancy rate than obtained from NOA by TESE, while live birth rate was not largely different in both groups