Effect of ovarian reserve on pregnancy outcomes in patients undergoing IVF treatment due to azoospermia.

Abstract

Purpose: Infertility is an increasingly common condition that has demographic, psychological, economic, and medical consequences for society. Although many studies have examined azoospermia (AZO) and diminished ovarian reserve (DOR), few have investigated these two groups together. In this study, we aimed to contribute to the literature by comparing these conditions, which can be challenging for physicians and patients.

Methods: The study included couples with AZO and/or DOR who underwent intracytoplasmic sperm injection (ICSI) at Tepecik Training and Research Hospital Gynecology and Obstetrics Clinic In Vitro Fertilization (IVF) Center between 01 January 2017 and 30 June 2023. A total of 100 couples meeting the inclusion criteria were divided into 3 groups according to treatment indication: AZO (n = 34), DOR (n = 34), and AZO + DOR (n = 32). The women's ages, basal hormone levels (follicle-stimulating hormone, estradiol, progesterone, anti-Müllerian hormone), treatment indications, day of embryo transfer, and clinical pregnancy outcomes were documented.

Results: Clinical pregnancy rates were 64.7% in the AZO group, 50% in the DOR group, and 34.4% in the DOR + AZO group. In pairwise comparisons, the clinical pregnancy rate was significantly higher in the AZO group than in the DOR + AZO group (p = 0.014). The live birth rate was also significantly lower in the DOR + AZO group than in the AZO group (p = 0.022). In the DOR group, 70.6% of achieved pregnancies resulted in live birth and 29.4% in missed abortion.

Conclusion: Clinical pregnancy and live birth rates were found to be significantly higher in couples with AZO compared to those with both DOR and AZO. This suggests that the woman's ovarian reserve is more decisive than sperm quality in the success of IVF/ICSI.